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Erschienen in: Infection 4/2022

19.01.2022 | Original Paper

Evaluation of early clinical failure criteria in Enterococcus species bloodstream infection

verfasst von: Caroline E. Powers, P. Brandon Bookstaver, Celeste Caulder, Abigail Bouknight, Julie Ann Justo, Joseph Kohn, Hana Rac Winders, Majdi N. Al-Hasan

Erschienen in: Infection | Ausgabe 4/2022

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Abstract

Purpose

Early clinical failure criteria (ECFC) were recently introduced to predict unfavorable outcomes in patients with Gram-negative bloodstream infections (BSI). ECFC include hypotension, tachycardia, tachypnea or mechanical ventilation, altered mental status, and leukocytosis evaluated at 72–96 h after BSI. The aim of this retrospective cohort study was to assess performance of ECFC in predicting 28-day mortality in Enterococcus species BSI.

Methods

Hospitalized adults with Enterococcus species BSI at Prisma Health hospitals from 1 January 2015 to 31 July 2018 were identified. Multivariate logistic regression was used to determine the association between ECFC and 28-day mortality. Area under the receiver operating characteristic (AUROC) curve was used to measure model discrimination.

Results

Among 157 patients, 28 (18%) died within 28 days of BSI. After adjustments in multivariate model, the risk of 28-day mortality increased in the presence of each additional ECFC (OR 1.6, 95% CI 1.2–2.3, p = 0.005). Infective endocarditis (OR 3.9, 95% CI 1.4–10.7, p = 0.01) was independently associated with 28-day mortality. AUROC curve of ECFC model in predicting 28-day mortality was 0.74 with ECFC of 2 identified as the best breakpoint. Mortality was 8% in patients with ECFC < 2 compared to 33% in those with ECFC ≥ 2 (p < 0.001).

Conclusion

ECFC had good discrimination in predicting 28-day mortality in patients with Enterococcus species BSI. These criteria may have utility in future clinical investigations.
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Metadaten
Titel
Evaluation of early clinical failure criteria in Enterococcus species bloodstream infection
verfasst von
Caroline E. Powers
P. Brandon Bookstaver
Celeste Caulder
Abigail Bouknight
Julie Ann Justo
Joseph Kohn
Hana Rac Winders
Majdi N. Al-Hasan
Publikationsdatum
19.01.2022
Verlag
Springer Berlin Heidelberg
Erschienen in
Infection / Ausgabe 4/2022
Print ISSN: 0300-8126
Elektronische ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-022-01754-6

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