Cargando…

Initial indicators for the prognosis of Acinetobacter Baumannii bacteremia in children

BACKGROUND: Risk factors related to mortality due to Acinetobacter baumannii (AB) bacteremia have been unveiled previously, but early clinical manifestations of AB bacteremia based on prognosis remain uncovered. METHODS: The demographic characteristics, clinical features, antibiotic susceptibility,...

Descripción completa

Detalles Bibliográficos
Autores principales: Hong, Yi, Lin, Xiaochen, Zhang, Chunxu, Dong, Xingqiang, Lu, Meihua, Huang, Saihu, Huang, Lili, Su, Chunmei, Bai, Zhenjiang, Wu, Shuiyan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10542241/
https://www.ncbi.nlm.nih.gov/pubmed/37775747
http://dx.doi.org/10.1186/s12879-023-08639-5
_version_ 1785114052193681408
author Hong, Yi
Lin, Xiaochen
Zhang, Chunxu
Dong, Xingqiang
Lu, Meihua
Huang, Saihu
Huang, Lili
Su, Chunmei
Bai, Zhenjiang
Wu, Shuiyan
author_facet Hong, Yi
Lin, Xiaochen
Zhang, Chunxu
Dong, Xingqiang
Lu, Meihua
Huang, Saihu
Huang, Lili
Su, Chunmei
Bai, Zhenjiang
Wu, Shuiyan
author_sort Hong, Yi
collection PubMed
description BACKGROUND: Risk factors related to mortality due to Acinetobacter baumannii (AB) bacteremia have been unveiled previously, but early clinical manifestations of AB bacteremia based on prognosis remain uncovered. METHODS: The demographic characteristics, clinical features, antibiotic susceptibility, and outcomes of 37 hospitalized children with laboratory-confirmed AB bacteremia from Suzhou, China, were collected and analyzed retrospectively. RESULTS: Of the 37 children with AB bacteremia included in this study, 23 were males and 14 were females, with a median age of 4.83 (0.60 to 10.15) years. Among the children, 18 died (48.65%, 18/37) and 19 survived (51.35%, 19/37). The dead group had a significantly higher incidence of respiratory failure (p = 0.008), shock (P = 0.000), MODS (p = 0.000), neutropenia (< 1.5 × 10(9)/L) (p = 0.000) and serious neutropenia (< 0.5 × 10(9)/L) (p = 0.000) than those in the survival group. The death group had significantly more invasive procedures (2 or more) than that in the survival group at 2 weeks before onset (p = 0.005). The proportion of MDR-AB in the death group was significantly higher than that in the survival group (p = 0.000), while the PICS score was significantly lower in the survival group than that in the death group (p = 0.000). There was no significant difference in effective antibiotic use within 24 h between these two groups (p = 0.295). Among the 37 children with bloodstream infection of AB, 56.76% (21/37) of the underlying diseases were hematological diseases and oncology. Among them, 17 (81.00%) were died in the hospital. The proportion of white blood cells (p = 0.000), neutrophils (p = 0.042), eosinophils (p = 0.029), the ANC (p = 0.000) and lymphocyte (p = 0.000), the NLR(p = 0.011), hemoglobin (p = 0.001), platelets (p = 0.000), prealbumin (P = 0.000), LDH (p = 0.017), blood gas pH (p = 0.000), and serum potassium (p = 0.002) in the death group were significantly lower than those in the survival group. However, CRP (p = 0.000) and blood glucose(p = 0.036) were significantly higher in the death group than those in the survival group. By further multivariate analysis, CRP [OR (95% CI): 1.022(1.003, 1.041), p = 0.021] and neutropenia [OR (95% CI): 21.634 (2.05, 228.313, p = 0.011] within 24 h of infection were independent risk factors for death in children with AB bacteremia. When CRP was higher than 59.02 mg/L, the sensitivity of predicting mortality was 88.9%, and the specificity was 78.9%. And the sensitivity and specificity of neutropenia for predicting mortality were 83.3% and 84.2%. CONCLUSIONS: AB bacteremia has a high mortality in children, especially in patients with hematological diseases and oncology. Many early indicators were associated with poor prognosis, while elevated CRP and neutropenia were the independent predictors for the 30-day mortality of children with laboratory-confirmed AB bacteremia.
format Online
Article
Text
id pubmed-10542241
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-105422412023-10-03 Initial indicators for the prognosis of Acinetobacter Baumannii bacteremia in children Hong, Yi Lin, Xiaochen Zhang, Chunxu Dong, Xingqiang Lu, Meihua Huang, Saihu Huang, Lili Su, Chunmei Bai, Zhenjiang Wu, Shuiyan BMC Infect Dis Research BACKGROUND: Risk factors related to mortality due to Acinetobacter baumannii (AB) bacteremia have been unveiled previously, but early clinical manifestations of AB bacteremia based on prognosis remain uncovered. METHODS: The demographic characteristics, clinical features, antibiotic susceptibility, and outcomes of 37 hospitalized children with laboratory-confirmed AB bacteremia from Suzhou, China, were collected and analyzed retrospectively. RESULTS: Of the 37 children with AB bacteremia included in this study, 23 were males and 14 were females, with a median age of 4.83 (0.60 to 10.15) years. Among the children, 18 died (48.65%, 18/37) and 19 survived (51.35%, 19/37). The dead group had a significantly higher incidence of respiratory failure (p = 0.008), shock (P = 0.000), MODS (p = 0.000), neutropenia (< 1.5 × 10(9)/L) (p = 0.000) and serious neutropenia (< 0.5 × 10(9)/L) (p = 0.000) than those in the survival group. The death group had significantly more invasive procedures (2 or more) than that in the survival group at 2 weeks before onset (p = 0.005). The proportion of MDR-AB in the death group was significantly higher than that in the survival group (p = 0.000), while the PICS score was significantly lower in the survival group than that in the death group (p = 0.000). There was no significant difference in effective antibiotic use within 24 h between these two groups (p = 0.295). Among the 37 children with bloodstream infection of AB, 56.76% (21/37) of the underlying diseases were hematological diseases and oncology. Among them, 17 (81.00%) were died in the hospital. The proportion of white blood cells (p = 0.000), neutrophils (p = 0.042), eosinophils (p = 0.029), the ANC (p = 0.000) and lymphocyte (p = 0.000), the NLR(p = 0.011), hemoglobin (p = 0.001), platelets (p = 0.000), prealbumin (P = 0.000), LDH (p = 0.017), blood gas pH (p = 0.000), and serum potassium (p = 0.002) in the death group were significantly lower than those in the survival group. However, CRP (p = 0.000) and blood glucose(p = 0.036) were significantly higher in the death group than those in the survival group. By further multivariate analysis, CRP [OR (95% CI): 1.022(1.003, 1.041), p = 0.021] and neutropenia [OR (95% CI): 21.634 (2.05, 228.313, p = 0.011] within 24 h of infection were independent risk factors for death in children with AB bacteremia. When CRP was higher than 59.02 mg/L, the sensitivity of predicting mortality was 88.9%, and the specificity was 78.9%. And the sensitivity and specificity of neutropenia for predicting mortality were 83.3% and 84.2%. CONCLUSIONS: AB bacteremia has a high mortality in children, especially in patients with hematological diseases and oncology. Many early indicators were associated with poor prognosis, while elevated CRP and neutropenia were the independent predictors for the 30-day mortality of children with laboratory-confirmed AB bacteremia. BioMed Central 2023-09-29 /pmc/articles/PMC10542241/ /pubmed/37775747 http://dx.doi.org/10.1186/s12879-023-08639-5 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Hong, Yi
Lin, Xiaochen
Zhang, Chunxu
Dong, Xingqiang
Lu, Meihua
Huang, Saihu
Huang, Lili
Su, Chunmei
Bai, Zhenjiang
Wu, Shuiyan
Initial indicators for the prognosis of Acinetobacter Baumannii bacteremia in children
title Initial indicators for the prognosis of Acinetobacter Baumannii bacteremia in children
title_full Initial indicators for the prognosis of Acinetobacter Baumannii bacteremia in children
title_fullStr Initial indicators for the prognosis of Acinetobacter Baumannii bacteremia in children
title_full_unstemmed Initial indicators for the prognosis of Acinetobacter Baumannii bacteremia in children
title_short Initial indicators for the prognosis of Acinetobacter Baumannii bacteremia in children
title_sort initial indicators for the prognosis of acinetobacter baumannii bacteremia in children
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10542241/
https://www.ncbi.nlm.nih.gov/pubmed/37775747
http://dx.doi.org/10.1186/s12879-023-08639-5
work_keys_str_mv AT hongyi initialindicatorsfortheprognosisofacinetobacterbaumanniibacteremiainchildren
AT linxiaochen initialindicatorsfortheprognosisofacinetobacterbaumanniibacteremiainchildren
AT zhangchunxu initialindicatorsfortheprognosisofacinetobacterbaumanniibacteremiainchildren
AT dongxingqiang initialindicatorsfortheprognosisofacinetobacterbaumanniibacteremiainchildren
AT lumeihua initialindicatorsfortheprognosisofacinetobacterbaumanniibacteremiainchildren
AT huangsaihu initialindicatorsfortheprognosisofacinetobacterbaumanniibacteremiainchildren
AT huanglili initialindicatorsfortheprognosisofacinetobacterbaumanniibacteremiainchildren
AT suchunmei initialindicatorsfortheprognosisofacinetobacterbaumanniibacteremiainchildren
AT baizhenjiang initialindicatorsfortheprognosisofacinetobacterbaumanniibacteremiainchildren
AT wushuiyan initialindicatorsfortheprognosisofacinetobacterbaumanniibacteremiainchildren