David Erlanger1, Marc Victor Assous2, Yonit Wiener-Well3, Amos Moshe Yinnon4, Eli Ben-Chetrit5. 1. Infectious Diseases Unit, Shaare Zedek Medical Center, Affiliated with the Hebrew-University-Hadassah Medical School, Faculty of Medicine, Jerusalem, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Israel. 2. Clinical Microbiology and Immunology Laboratory, Shaare Zedek Medical Center, Affiliated with the Hebrew-University-Hadassah Medical School, Faculty of Medicine, Jerusalem, Israel. 3. Infectious Diseases Unit, Shaare Zedek Medical Center, Affiliated with the Hebrew-University-Hadassah Medical School, Faculty of Medicine, Jerusalem, Israel. 4. Division of Internal Medicine, Shaare Zedek Medical Center, Affiliated with the Hebrew-University-Hadassah Medical School, Faculty of Medicine, Jerusalem, Israel. 5. Infectious Diseases Unit, Shaare Zedek Medical Center, Affiliated with the Hebrew-University-Hadassah Medical School, Faculty of Medicine, Jerusalem, Israel. Electronic address: elibc1@yahoo.com.
Abstract
BACKGROUND: There are few studies of Morganella bacteremia. We evaluated risk factors and outcome of patients with Morganella bacteremia. METHODS: Medical records of patients with Morganella bacteremia were reviewed (1997-2014). Control group patients with Escherichiacoli sepsis were matched by year of diagnosis and infection acquisition site. RESULTS: The study group included 136 adult patients. Mean age and gender of study and control groups were similar. Complicated soft tissue infection was more prevalent in the study group (30% versus 3.2%, p < 0.05). The Charlson Comorbidity Index (CCI) was higher in the study group (4.3 ± 2.5 versus 3.4 ± 2.8, p < 0.05). Only 78 (62%) of the study patients versus 101 (83%) of the control group (p < 0.05), received appropriate empirical antibiotic treatment. A significantly higher in-hospital mortality rate (42% versus 25%, p < 0.05) as well as longer length of stay (25 ± 22 versus 14 ± 16 days, p < 0.05) was observed in the study group. Multivariate analysis revealed that a debilitative state, a CCI > 4, septic shock and a clinical syndrome other than UTI were all significant risk factors for mortality (p < 0.05). CONCLUSIONS: Patients with Morganellamorganii sepsis had more co-morbidities and a worse degree of sepsis. There is an increased risk of inappropriate empirical treatment, longer hospitalization and higher death rate.
BACKGROUND: There are few studies of Morganella bacteremia. We evaluated risk factors and outcome of patients with Morganella bacteremia. METHODS: Medical records of patients with Morganella bacteremia were reviewed (1997-2014). Control group patients with Escherichiacoli sepsis were matched by year of diagnosis and infection acquisition site. RESULTS: The study group included 136 adult patients. Mean age and gender of study and control groups were similar. Complicated soft tissue infection was more prevalent in the study group (30% versus 3.2%, p < 0.05). The Charlson Comorbidity Index (CCI) was higher in the study group (4.3 ± 2.5 versus 3.4 ± 2.8, p < 0.05). Only 78 (62%) of the study patients versus 101 (83%) of the control group (p < 0.05), received appropriate empirical antibiotic treatment. A significantly higher in-hospital mortality rate (42% versus 25%, p < 0.05) as well as longer length of stay (25 ± 22 versus 14 ± 16 days, p < 0.05) was observed in the study group. Multivariate analysis revealed that a debilitative state, a CCI > 4, septic shock and a clinical syndrome other than UTI were all significant risk factors for mortality (p < 0.05). CONCLUSIONS:Patients with Morganellamorganiisepsis had more co-morbidities and a worse degree of sepsis. There is an increased risk of inappropriate empirical treatment, longer hospitalization and higher death rate.