Publication: Epidemiology of bacteremia caused by uncommon non-fermentative gram-negative bacteria
Issued Date
2013
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eng
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Mahidol University
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BioMed Central
Bibliographic Citation
BMC Infectious Diseases. Vol. 13, (2013), 167
Suggested Citation
Pinyo Rattanaumpawan, Prapassorn Ussavasodhi, Pattarachai Kiratisin, Nalinee Aswapokee Epidemiology of bacteremia caused by uncommon non-fermentative gram-negative bacteria. BMC Infectious Diseases. Vol. 13, (2013), 167. doi:10.1186/1471-2334-13-167 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/2651
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Title
Epidemiology of bacteremia caused by uncommon non-fermentative gram-negative bacteria
Abstract
Background: Prevalence of bacteremia caused by non-fermentative gram-negative bacteria (NFGNB) has been
increasing over the past decade. Although many studies have already investigated epidemiology of NFGNB
bacteremia, most focused only on common NFGNB including Pseudomonas aeruginosa (PA) and Acinetobacter
baumannii (AB). Knowledge of uncommon NFGNB bacteremia is very limited. Our study aimed to investigate
epidemiology and identify factors associated with uncommon NFGNB bacteremia.
Methods: This observational study was conducted at a university hospital in Thailand during July 1, 2007-Dec 31,
2008. All patients who had at least one blood culture positive for NFGNB and met the criteria for systemic
inflammatory response syndrome within 24 hours before/after obtaining the blood culture were enrolled. The
NFGNB isolates that could not be satisfactorily identified by the standard biochemical assays were further
characterized by molecular sequencing methods. To identify factors associated with uncommon NFGNB bacteremia,
characteristics of patients in the uncommon NFGNB group were subsequently compared to patients in the
common NFGNB group (AB and PA bacteremia).
Results: Our study detected 223 clinical isolates of NFGNB in 221 unique patients. The major causative pathogens
were AB (32.7%), followed by PA (27.8%), Stenotrophomonas maltophilia (5.4%), Acinetobacter lwoffii (4.9%) and
Burkholderia pseudomallei (2.7%). Infection-related mortality was 63.0% in the AB group, 40.3% in the PA group and
17.4% in the uncommon NFGNB group. Factors associated with uncommon NFGNB bacteremia (OR [95% CI];
p-value) were male sex (0.28 [0.14-0.53]; p < 0.001), hospital-acquired infection (0.23 [0.11-0.51]; p < 0.001), recent
aminoglycosides exposure 0.23 [0.06-0.8]; p = 0.01), primary bacteremia (6.43 [2.89-14.2]; p < 0.001]), catheter related
infection (4.48 [1.54-13.06]; p < 0.001) and recent vancomycin exposure (3.88 [1.35-11.1]; p = 0.02).
Conclusions: Our distribution of causative pathogens was slightly different from other studies. The common
NFGNB group had a remarkably higher ID-mortality than the uncommon NFGNB group. Knowledge of factors
associated with uncommon NFGNB bacteremia would help physicians to distinguish between low vs. high risk
patients.