Carbapenem-resistant Gram-negative pathogens associated with septic shock: a review of 120 cases


ÖNAL U. , AKYOL D. , MERT M. , Baskol D., Memetali S. C. , Sanlidag G., ...More

JOURNAL OF CHEMOTHERAPY, 2022 (Journal Indexed in SCI) identifier identifier

  • Publication Type: Article / Review
  • Publication Date: 2022
  • Doi Number: 10.1080/1120009x.2022.2064703
  • Title of Journal : JOURNAL OF CHEMOTHERAPY
  • Keywords: Carbapenem resistance, Gram-negative pathogens, septic shock, INFECTIOUS-DISEASES-SOCIETY, CLINICAL-PRACTICE GUIDELINES, MANAGEMENT, MORTALITY, SEPSIS, PNEUMONIA, DIAGNOSIS, ADULTS

Abstract

This study aimed to evaluate the influencing variables for outcomes in patients with septic shock having culture-proven carbapenem-resistant Gram-negative pathogens. It included 120 patients (mean age 64.29 +/- 1.35 years and 58.3% female). The mean Sequential Organ Failure Assessment score during septic shock diagnosis was found to be 11.22 +/- 0.43 and 9 +/- 0.79 among the patients with mortality and among the survivors, respectively (P = 0.017). The logistic regression analysis showed that empirical treatment as mono Gram-negative bacteria-oriented antibiotic therapy (P = 0.016, odds ratio (OR) = 17.730, 95% confidence interval (CI): 1.728-182.691), Charlson Comorbidity Index >2 (P = 0.032, OR = 7.312, 95% CI: 5.7-18.3), and systemic inflammatory response syndrome score 3 or 4 during septic shock diagnosis (P = 0.014, OR = 5.675, 95% CI: 1.424-22.619) were found as independent risk factors for day 30 mortality. Despite early diagnosis and effective management of patients with septic shock, the mortality rates are quite high in CRGNP-infected patients.