Thomas P Lodise1, Hemanth Kanakamedala2, Wei-Chun Hsu2, Bin Cai3. 1. Albany College of Pharmacy and Health Sciences, Albany, New York, USA. 2. Genesis Research Inc, Hoboken, New Jersey, USA. 3. Shionogi Inc, Florham Park, New Jersey, USA.
Abstract
BACKGROUND: Serious bloodstream infections (BSIs) are often caused by Gram-negative (GN) bacteria in hospitalized patients. Treatment of these infections has been further complicated by the continued rise and spread of drug-resistant pathogens, including carbapenem resistant (CR) strains of Enterobacteriaceae, Acinetobacter baumannii, and Pseudomonas aeruginosa. METHODS: This retrospective cohort analysis used real-world data from a large United States hospital-based database to examine the association between key clinical outcomes and different lengths of time to appropriate treatment between October 2010 and September 2015. RESULTS: Of 40,549 patients with GN-BSIs who were identified, 1117 (2.8%) had a CR GN-BSI. Overall, outcomes of hospitalized adult patients with GN-BSIs incrementally worsened the longer appropriate therapy was delayed. Patients with CR GN-BSIs had a median infection-associated length of stay (LOS) of 8, 9, 10, and 13 days, whereas patients with CS GN-BSIs had a median infection-associated LOS of 6, 7, 8, and 11 days for patients with days to appropriate therapy of 0, 1-2, 3-4, and ≥ 5 days, respectively. Among patients with CR GN-BSIs, the percentage of patients discharged home was 38%, 33%, 35%, and 31%, whereas in patients with CS GN-BSIs, the percentage of patients discharged home was 58%, 53%, 48%, and 43% for patients with days to appropriate therapy of 0, 1-2, 3-4, and ≥ 5 days, respectively. CONCLUSION: The findings from this study highlight the clear need to deliver appropriate therapy more expeditiously in patients with CS and CR GN-BSIs.
BACKGROUND: Serious bloodstream infections (BSIs) are often caused by Gram-negative (GN) bacteria in hospitalized patients. Treatment of these infections has been further complicated by the continued rise and spread of drug-resistant pathogens, including carbapenem resistant (CR) strains of Enterobacteriaceae, Acinetobacter baumannii, and Pseudomonas aeruginosa. METHODS: This retrospective cohort analysis used real-world data from a large United States hospital-based database to examine the association between key clinical outcomes and different lengths of time to appropriate treatment between October 2010 and September 2015. RESULTS: Of 40,549 patients with GN-BSIs who were identified, 1117 (2.8%) had a CR GN-BSI. Overall, outcomes of hospitalized adult patients with GN-BSIs incrementally worsened the longer appropriate therapy was delayed. Patients with CR GN-BSIs had a median infection-associated length of stay (LOS) of 8, 9, 10, and 13 days, whereas patients with CS GN-BSIs had a median infection-associated LOS of 6, 7, 8, and 11 days for patients with days to appropriate therapy of 0, 1-2, 3-4, and ≥ 5 days, respectively. Among patients with CR GN-BSIs, the percentage of patients discharged home was 38%, 33%, 35%, and 31%, whereas in patients with CS GN-BSIs, the percentage of patients discharged home was 58%, 53%, 48%, and 43% for patients with days to appropriate therapy of 0, 1-2, 3-4, and ≥ 5 days, respectively. CONCLUSION: The findings from this study highlight the clear need to deliver appropriate therapy more expeditiously in patients with CS and CR GN-BSIs.
Authors: Alyssa B Christensen; Brent Footer; Tobias Pusch; Kim Heath; Maha Iqbal; Lian Wang; Gregory Tallman; Cameron Cover; Jennifer Marfori; Brian Kendall; Nick Stucky; Meagan Greckel; Ivor L Thomas; Katelynn Tran; Salena Yip; Margret Oethinger Journal: Open Forum Infect Dis Date: 2022-07-22 Impact factor: 4.423