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Burden and mortality of sepsis and septic shock at a high-volume, single-center in Vietnam: a retrospective study
Hospital practice (1995) Số 5, năm 2022 (Tập 50, trang 407-415)
ISSN: 21548331
ISSN: 21548331
DOI: 10.1080/21548331.2022.2133414
Tài liệu thuộc danh mục:
Article
English
Từ khóa: Adult; Aged; Anti-Bacterial Agents; Escherichia coli; Female; Humans; Male; Middle Aged; Retrospective Studies; Sepsis; Shock, Septic; Staphylococcus aureus; Vietnam; antiinfective agent; adult; aged; epidemiology; Escherichia coli; female; human; male; middle aged; retrospective study; sepsis; septic shock; Staphylococcus aureus; Viet Nam
Tóm tắt tiếng anh
BACKGROUND: Sepsis and septic shock have high mortality rates and often require a prolonged hospital stay. Patient outcomes may vary according to multiple factors. We aim to determine the prevalence of antimicrobial resistance and factors associated with mortality and hospital stay. METHODS: Clinical and microbiological data of patients with sepsis or septic shock were retrospectively collected for 15months. Patients with negative blood cultures and patients that did not meet the SEPSIS 3 criteria were excluded. RESULTS: We included 48 septic shock and 28 septic patients (mean APACHE II 20.325.61 and mean SOFA 9.413.17), with a mean age of 60.516.8years and 56.6% males. WBCs, neutrophils, INR, and fibrinogen levels were significantly associated with mortality. 59.5% of the cultured bacteria were gram-negative (most common E. coli) and 27.8% were gram-positive (most common S.aureus), while 7.6% were other types of bacteria and 5.1% were fungi. Resistance patterns to gram-negative were varying, and resistance to piperacillin/tazobactam, carbapenems, and aminoglycosides were from 60% to 100% (A. baumanii), while they were highly sensitive to Colistin. E. coli was also resistant to ceftriaxone (77.8%) and sulbactam/cefoperazone (44.4%). Resistance rates for Gram-positives were high, from 86% to 100% for oxacillin, while for vancomycin, teicoplanin, and linezolid, they were often low but arrived up to 42.8%. According to our logistic regression analysis, patients over 65year-old and those who received corticosteroids had a significantly increased risk of in-hospital mortality (OR: 4.0; OR: 4.8). CONCLUSION: Sepsis still poses a significant threat to patients' health, even when positive blood culture results allow the administration of specific antibiotic treatment.