Risk Factors for Mortality in Patients with Serratia marcescens Bacteremia
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Purpose: Over the last 30 years, Serratia marcescens (S. marcescens) has emerged as an important pathogen, and a common cause of nosocomial infections. The aim of this study was to identify risk factors associated with mortality in patients with S. marcescens bacteremia. Materials and Methods: We performed a retrospective cohort study of 98 patients who had one or more blood cultures positive for S. marcescens between January 2006 and December 2012 in a tertiary care hospital in Seoul, South Korea. Multiple risk factors were compared with association with 28-day all-cause mortality. Results: The 28-day mortality was 22.4% (22/98 episodes). In a univariate analysis, the onset of bacteremia during the intensive care unit stay (p=0.020), serum albumin level (p=0.011), serum C-reactive protein level (p=0.041), presence of indwelling urinary catheter (p=0.023), and Sequential Oran Failure Assessment (SOFA) score at the onset of bacteremia (p<0.001) were significantlydifferent between patients in the fatal and non-fatal groups. In a multivariateanalysis, lower serum albumin level and an elevated SOFA score were independentlyassociated with 28-day mortality [adjusted odds ratio (OR) 0.206, 95% confidential interval (CI) 0.044‒0.960, p=0.040, and adjusted OR 1.474, 95% CI 1.200‒1.810, p<0.001, respectively]. Conclusion: Lower serum albumin level and an elevated SOFA score were significantly associated with adverse outcomes in patients with S. marcescens bacteremia.
Abstract
Purpose: Over the last 30 years, Serratia marcescens (S. marcescens) has emerged as an important pathogen, and a common cause of nosocomial infections. The aim of this study was to identify risk factors associated with mortality in patients with S. marcescens bacteremia. Materials and Methods: We performed a retrospective cohort study of 98 patients who had one or more blood cultures positive for S. marcescens between January 2006 and December 2012 in a tertiary care hospital in Seoul, South Korea. Multiple risk factors were compared with association with 28-day all-cause mortality. Results: The 28-day mortality was 22.4% (22/98 episodes). In a univariate analysis, the onset of bacteremia during the intensive care unit stay (p=0.020), serum albumin level (p=0.011), serum C-reactive protein level (p=0.041), presence of indwelling urinary catheter (p=0.023), and Sequential Oran Failure Assessment (SOFA) score at the onset of bacteremia (p<0.001) were significantlydifferent between patients in the fatal and non-fatal groups. In a multivariateanalysis, lower serum albumin level and an elevated SOFA score were independentlyassociated with 28-day mortality [adjusted odds ratio (OR) 0.206, 95% confidential interval (CI) 0.044‒0.960, p=0.040, and adjusted OR 1.474, 95% CI 1.200‒1.810, p<0.001, respectively]. Conclusion: Lower serum albumin level and an elevated SOFA score were significantly associated with adverse outcomes in patients with S. marcescens bacteremia.
참고문헌 (38)
- Eisenstein BI, "Principles and practice of infectious diseases", pp.2297~2310 (2000), Churchill Livingstone
- Yu VL, "Serratia marcescens: historical perspective and clinical review", N Engl J Med, 300, pp.887~893 (1979)
- Henjyoji EY, "Bacteremia due to Serratia marcescens", J Trau, 11, pp.417~421 (1971)
- Luzzaro F, "Repeated epidemics caused by extended-spectrum beta-lactamase-producing Serratia marcescens strains", Eur J Clin Microbiol Infect Dis, 17, pp.629~636 (1998)
- Bonnet R, "A novel class A extended-spectrum beta-lactamase (BES-1) in Serratia marcescens isolated in Brazil", Antimicrob Agents Chemother, 44, pp.3061~3068 (2000)
- Ivanova D, "Extended-spectrum beta-lactamase-producing Serratia marcescens outbreak in a Bulgarian hospital", J Hosp Infect, 70, pp.60~65 (2008)
- Saito H, "Serratia bacteremia: review of 118 cases", Rev Infect Dis, 11, pp.912~920 (1989)
- Wong WW, "Serratia marcescens bacteremia", J Formos Med Assoc, 90, pp.88~93 (1991)
- Yu WL, "Serratia marcescens bacteremia: clinical features and antimicrobial susceptibilities of the isolates", J Microbiol Immunol Infect, 31, pp.171~179 (1998)
- Shih HI, "Serratia marcescens bacteremia at a medical center in southern Taiwan: high prevalence of cefotaxime resistance", J Microbiol Immunol Infect, 38, pp.350~357 (2005)
- Cheong HS, "Clinical significance of infections caused by extended-spectrum β-lactamase-producing Enterobacteriaceae blood isolates with inducible AmpC β-lactamase", Microb Drug Resist, 18, pp.446~452 (2012)
- Choi SH, "Serratia bacteremia in a large university hospital: trends in antibiotic resistance during 10 years and implications for antibiotic use", Infect Control Hosp Epidemiol, 23, pp.740~747 (2002)
- Engel HJ, "Serratia sp. bacteremia in Canberra, Australia: a population-based study over 10 years", Eur J Clin Microbiol Infect Dis, 28, pp.821~824 (2009)
- Vincent JL, "Use of the SOFA score to assess the incidence of organ dysfunction", failure in intensive care units: results of a multicenter, prospective study. Working group on “sepsis-related problems” of the European Society of Intensive Care Medicine, 1998, pp.26, 1793~1800
- Kang CI, "Bloodstream infections caused by Enterobacter species: predictors of 30-day mortality rate and impact of broad-spectrum cephalosporin resistance on outcome", Clin Infect Dis, 39, pp.812~818 (2004)
- Friedman ND, "Health care--associated bloodstream infections in adults: a reason to change the accepted definition of community-acquired infections", Ann Intern Med, 137, pp.791~797 (2002)
- Marik PE, "The definition of septic shock: implications for treatment", Crit Care Resusc, 9, pp.101~103 (2007)
- World Health Organization, "International statistical classification of diseases and related health problems. 10th revision", World Health Organization, ~ (2004)
- Harbarth S, "initial antimicrobial therapy and its effect on survival in a clinical trial of immunomodulating therapy for severe sepsis", Am J Med, 115, pp.529~535 (2003)
- McGregor JC, "A systematic review of the methods used to assess the association between appropriate antibiotic therapy and mortality in bacteremic patients", Clin Infect Dis, 45, pp.329~337 (2007)
- Song Sun Wha, "Clinical Role of Interstitial Pneumonia in Patients with Scrub Typhus: A Possible Marker of Disease Severity", Journal of Korean Medical Science, 19(5), pp.668~673 (2004), 대한의학회
- Carratalà J, "Factors associated with complications and mortality in adult patients hospitalized for infectious cellulitis", Eur J Clin Microbiol Infect Dis, 22, pp.151~157 (2003)
- Clinical and Laboratory Standards Institue, "Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Second Informational Supplement M100-S21", CLSI, ~ (2012)
- Haddy RI, "Nosocomial infection in the community hospital: severe infection due to Serratia species", J Fam Pra, 42, pp.273~277 (1996)
- Laupland KB, "Population-based laboratory surveillance for Serratia species isolates in a large Canadian health region", Eur J Clin Microbiol Infect Dis, 27, pp.89~95 (2008)
- Park YJ, "Occurrence of extended-spectrum beta-lactamases among chromosomal AmpC-producing Enterobacter cloacae, Citrobacter freundii, and Serratia marcescens in Korea and investigation of screening criteria", Diagn Microbiol Infect Dis, 51, pp.265~269 (2005)
- Nordmann P, "Global spread of Carbapenemase-producing Enterobacteriaceae", Emerg Infect Dis, 17, pp.1791~1798 (2011)
- Kim SY, "Characteristics of carbapenem-resistant Enterobacteriaceae isolates from Korea", Diagn Microbiol Infect Dis, 76, pp.486~490 (2013)
- Arribas JR, "Peña JM, et al. Prognostic factors in Serratia bacteremia", Rev Infect Dis, 12, pp.563~564 (1990)
- Ho PL, "Detection and characterization of extended-spectrum beta-lactamases among bloodstream isolates of Enterobacter spp. in Hong Kong, 2000-2002", J Antimicrob Chemother, 55, pp.326~332 (2005)
- Watanakunakorn C, "Serratia bacteremia: a review of 44 episodes", Scand J Infect Dis, 21, pp.477~483 (1989)
- Herrmann FR, "Serum albumin level on admission as a predictor of death, length of stay, and readmission", Arch Intern Med, 152, pp.125~130 (1992)
- Vincent JL, "Hypoalbuminemia in acute illness : is there a rationale for intervention? A meta-analysis of cohort studies and controlled trials", Ann Surg, 237, pp.319~334 (2003)
- Ulldemolins M, "The effects of hypoalbuminaemia on optimizing antibacterial dosing in critically ill patients", Clin Pharmacokinet, 50, pp.99~110 (2011)
- Routsi C, "Application of the sequential organ failure assessment (SOFA) score to bacteremic ICU patients", Infection, 35, pp.240~244 (2007)
- Anami EH, "Serial evaluation of SOFA score in a Brazilian teaching hospital", Intensive Crit Care Nurs, 26, pp.75~82 (2010)
- Ku NS, "Risk factors for mortality in patients with Burkholderia cepacia complex bacteraemia", Scand J Infect Dis, 43, pp.792~797 (2011)
- Kim BN, "Outcome of antibiotic therapy for third-generation cephalosporin-resistant Gram-negative bacteraemia: an analysis of 249 cases caused by Citrobacter, Enterobacter and Serratia species", Int J Antimicrob Agents, 22, pp.106~111 (2003)