George Dabar1, Carine Harmouche2, Pascale Salameh3, Bertrand L Jaber4, Ghassan Jamaleddine5, Mirna Waked6, Patricia Yazbeck7. 1. Hotel Dieu de France Hospital, Pulmonary and Critical Care Division, Saint Joseph University School of Medicine, PO Box 16-6830, Achrafieh Beirut, Lebanon. Electronic address: georges.dabar@usj.edu.lb. 2. Hotel Dieu de France Hospital, Pulmonary and Critical Care Division, Saint Joseph University School of Medicine, PO Box 16-6830, Achrafieh Beirut, Lebanon. 3. Lebanese University, Faculties of Pharmacy and of Public Health II, Beirut, Lebanon. 4. Kidney and Dialysis Research Laboratory, Division of Nephrology, Department of Medicine, Saint Elizabeth's Medical Center, Boston, Massachusetts, USA. 5. Kings County Hospital Center, Pulmonary and Critical Care Department, Brooklyn, New York, USA. 6. Saint George Hospital, Pulmonary and Critical Care Department, Beirut, Lebanon. 7. Hotel Dieu de France Hospital, Anesthesia and Critical Care Division, Saint Joseph University School of Medicine, Beirut, Lebanon.
Abstract
OBJECTIVE: To compare the spectrum of infection, comorbidities, outcomes, and mortality of patients admitted to the intensive care unit (ICU) due to community-acquired or healthcare-associated severe sepsis. METHODS: This prospective cohort study was conducted in three university medical centers in Lebanon from February 2005 to December 2006. Patients with severe sepsis were included and followed up until hospital discharge or death. RESULTS: One hundred and twenty patients were included of whom 60% had community-acquired infections (CAI) and 40% had healthcare-associated infections (HAI). The most common infection in both groups was pneumonia. Hematologic malignancies were the only comorbidity more prevalent in HAI than in CAI (p=0.047). Fungal infections and extended-spectrum beta-lactamase (ESBL) organisms were more frequent in HAI than in CAI (p=0.04 and 0.029, respectively). APACHE and SOFA scores were high and did not differ between the two groups, nor did the proportion of septic shock, while mortality was significantly higher in the HAI patients than in the CAI patients (p=0.004). On multivariate analysis for mortality, independent risk factors were the source of infection acquisition (p=0.004), APACHE II score (p=0.006), multidrug-resistant Pseudomonas infections (p=0.043), and fungal infections (p=0.006). CONCLUSIONS: Severe sepsis and septic shock had a high mortality rate, especially in the HAI group. Patients with risk factors for increased mortality should be monitored and aggressive treatment should be administered.
OBJECTIVE: To compare the spectrum of infection, comorbidities, outcomes, and mortality of patients admitted to the intensive care unit (ICU) due to community-acquired or healthcare-associated severe sepsis. METHODS: This prospective cohort study was conducted in three university medical centers in Lebanon from February 2005 to December 2006. Patients with severe sepsis were included and followed up until hospital discharge or death. RESULTS: One hundred and twenty patients were included of whom 60% had community-acquired infections (CAI) and 40% had healthcare-associated infections (HAI). The most common infection in both groups was pneumonia. Hematologic malignancies were the only comorbidity more prevalent in HAI than in CAI (p=0.047). Fungal infections and extended-spectrum beta-lactamase (ESBL) organisms were more frequent in HAI than in CAI (p=0.04 and 0.029, respectively). APACHE and SOFA scores were high and did not differ between the two groups, nor did the proportion of septic shock, while mortality was significantly higher in the HAI patients than in the CAI patients (p=0.004). On multivariate analysis for mortality, independent risk factors were the source of infection acquisition (p=0.004), APACHE II score (p=0.006), multidrug-resistant Pseudomonas infections (p=0.043), and fungal infections (p=0.006). CONCLUSIONS: Severe sepsis and septic shock had a high mortality rate, especially in the HAI group. Patients with risk factors for increased mortality should be monitored and aggressive treatment should be administered.
Authors: Hadi A Rabee; Raghad Tanbour; Zaher Nazzal; Yousef Hamshari; Yousef Habash; Ahmad Anaya; Abbas Iter; Mohammad Gharbeyah; Dina Abugaber Journal: Indian J Crit Care Med Date: 2020-07
Authors: Anthony A Iwuafor; Folasade T Ogunsola; Rita O Oladele; Oyin O Oduyebo; Ibironke Desalu; Chukwudi C Egwuatu; Agwu U Nnachi; Comfort N Akujobi; Ita O Ita; Godwin I Ogban Journal: PLoS One Date: 2016-10-24 Impact factor: 3.240
Authors: Robby Markwart; Hiroki Saito; Thomas Harder; Sara Tomczyk; Alessandro Cassini; Carolin Fleischmann-Struzek; Felix Reichert; Tim Eckmanns; Benedetta Allegranzi Journal: Intensive Care Med Date: 2020-06-26 Impact factor: 17.440
Authors: A Ioakeimidou; E Pagalou; M Kontogiorgi; E Antoniadou; K Kaziani; K Psaroulis; E J Giamarellos-Bourboulis; A Prekates; N Antonakos; P Lassale; C Gogos Journal: Eur J Clin Microbiol Infect Dis Date: 2017-04-28 Impact factor: 3.267