Data/hora: 16/06/2024 10:58:03

Provedor de dados: | Brazilian Journal of Infectious Diseases
País: | Brazil
Título: | Risk factors for mortality in patients with ventilator-associated pneumonia caused by carbapenem-resistant Enterobacteriaceae
Autores: | Tuon,Felipe F.; Graf,Maria Esther; Merlini,Alexandre; Rocha,Jaime L.; Stallbaum,Suellen; Arend,Lavinia N.; Pecoit-Filho,Roberto.
Data: | 2017-02-01
Ano: | 2017
Palavras-chave: | Carbapenemase-producing Klebsiella pneumoniae; Ventilator-associated pneumonia; Risk factors; Mortality; Treatment.
Resumo: | Abstract  Background: 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 &gt;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.
Tipo: | Info:eu-repo/semantics/article
Idioma: | Inglês
Identificador: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702017000100001
Editor: | Brazilian Society of Infectious Diseases
Relação: | 10.1016/j.bjid.2016.09.008
Formato: | text/html
Fonte: | Brazilian Journal of Infectious Diseases  v.21 n.1 2017
Fonte: | info:eu-repo/semantics/openAccess