Risk factors for mortality in patients with ventilator-associated pneumonia caused by carbapenem-resistant Enterobacteriaceae

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dc.contributor.authorTuon F.F.
dc.contributor.authorGraf M.E.
dc.contributor.authorMerlini A.
dc.contributor.authorRocha J.L.
dc.contributor.authorStallbaum S.
dc.contributor.authorArend L.N.
dc.contributor.authorPecoit-Filho R.
dc.date.accessioned2024-03-13T00:51:35Z
dc.date.available2024-03-13T00:51:35Z
dc.date.issued2017
dc.description.abstract© 2016 Sociedade Brasileira de InfectologiaBackground The ideal therapeutic option for ventilator associated pneumonia caused by carbapenem-resistant Enterobacteriaceae is not defined. The aim of this study was to assess mortality-associated risk factors in patients with VAP by CRE and determine the outcome of several treatment options. Methods This was a retrospective study performed in two tertiary hospitals involving patients with VAP caused by CRE between January 2010 and August 2014. The outcomes were mortality within 30 days of VAP diagnosis and overall mortality during hospital admission. Risk factors for mortality were assessed by comparing variables of survivors and non-survivors. Results One hundred and twelve patients with CRE-VAP were included, 73 (65%) male, median age 56 years. The 30-day mortality was 57.1% and the overall hospital mortality was 67%. In the binary logistic regression analysis, only age >50 years was independently associated to increased mortality. Polymyxin was the most used drug (47.5%), followed by tigecycline (29.2%) and aminoglycosides (2.4%). Combined therapy with two active drugs was used by 17 patients (20.8%). No therapeutic option was independently associated to survival. However, combined therapy with two active drugs was superior to the therapy with a single active drug when inappropriate therapy was the comparator (p = 0.044). The addition of carbapenem was not associated with increased survival. Conclusion The best therapeutic option for VAP by CRE is still not completely defined, but the therapy with at least two active drugs was superior in this study.
dc.description.firstpage1
dc.description.issuenumber1
dc.description.lastpage6
dc.description.volume21
dc.identifier.doi10.1016/j.bjid.2016.09.008
dc.identifier.issn1678-4391
dc.identifier.urihttps://dspace.mackenzie.br/handle/10899/35883
dc.relation.ispartofBrazilian Journal of Infectious Diseases
dc.rightsAcesso Aberto
dc.subject.otherlanguageCarbapenemase-producing Klebsiella pneumoniae
dc.subject.otherlanguageMortality
dc.subject.otherlanguageRisk factors
dc.subject.otherlanguageTreatment
dc.subject.otherlanguageVentilator-associated pneumonia
dc.titleRisk factors for mortality in patients with ventilator-associated pneumonia caused by carbapenem-resistant Enterobacteriaceae
dc.typeArtigo
local.scopus.citations29
local.scopus.eid2-s2.0-85008195211
local.scopus.subjectAdult
local.scopus.subjectAged
local.scopus.subjectAged, 80 and over
local.scopus.subjectAnti-Bacterial Agents
local.scopus.subjectCarbapenems
local.scopus.subjectCross-Sectional Studies
local.scopus.subjectDrug Resistance, Bacterial
local.scopus.subjectDrug Therapy, Combination
local.scopus.subjectEnterobacter aerogenes
local.scopus.subjectEnterobacteriaceae Infections
local.scopus.subjectFemale
local.scopus.subjectHospital Mortality
local.scopus.subjectHumans
local.scopus.subjectKlebsiella pneumoniae
local.scopus.subjectLogistic Models
local.scopus.subjectMale
local.scopus.subjectMiddle Aged
local.scopus.subjectPneumonia, Ventilator-Associated
local.scopus.subjectRetrospective Studies
local.scopus.subjectRisk Factors
local.scopus.subjectStatistics, Nonparametric
local.scopus.subjectTime Factors
local.scopus.subjectTreatment Outcome
local.scopus.updated2024-05-01
local.scopus.urlhttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85008195211&origin=inward
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