Abstract:
BACKGROUND:Severe infection is a main cause of mortality. We aim to describe risk factors for long-term mortality among inpatients with severe infection. METHODS:Prospective cohort study in a 600-bed university hospital in Portugal including all patients with severe infection admitted into intensive care, medical, surgical, hematology and nephrology wards over one-year period. The outcome of interest was 5-year mortality following infection. Variables of patient background and infectious episode were studied in association with the main outcome through multiple logistic regression. There were 1013 patients included in the study. Hospital and 5-year mortality rates were 14 and 37%, respectively. RESULTS:Two different models were developed (with and without acute-illness severity scores) and factors independently associated with 5-year mortality were [adjusted odds ratio (95% confidence interval)]: age = 1.03 per year (1.02-1.04), cancer = 4.36 (1.65-11.53), no comorbidities = 0.4 (0.26-0.62), Karnovsky Index < 70 = 2.25 (1.48-3.40), SAPS (Simplified Acute Physiology Score) II = 1.05 per point (1.03-1.07), positive blood cultures = 1.57 (1.01-2.44) and infection by an ESKAPE pathogen (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeroginosa and Enterobacter species) = 1.61 (1.00- 2.60); and in the second model [without SAPS II and SOFA (Sequential Organ Failure Assessment) scores]: age = 1.04 per year (1.03-1.05), cancer = 5.93 (2.26-15.51), chronic haematologic disease = 2.37 (1.14-4.93), no comorbidities = 0.45 (0.29-0.69), Karnovsky Index< 70 = 2.32 (1.54- 3.50), septic shock [reference is infection without SIRS (Systemic Inflammatory Response Syndrome)] = 3.77 (1.80-7.89) and infection by an ESKAPE pathogen = 1.61 (1.00-2.60). Both models presented a good discrimination power with an AU-ROC curve (95% CI) of 0.81 (0.77-0.84) for model 1 and 0.80 (0.76-0.83) for model 2. If only patients that survived hospital admission are included in the model, variables retained are: age = 1.03 per year (1.02-1.05), cancer = 4.69 (1.71-12.83), chronic respiratory disease = 2.27 (1.09-4.69), diabetes mellitus = 1.65 (1.06-2.56), Karnovsky Index < 70 = 2.50 (1.63-3.83) and positive blood cultures = 1.66 (1.04-2.64) with an AU-ROC curve of 0.77 (0.73-0.81). CONCLUSIONS:Age, previous comorbidities, and functional status and infection by an ESKAPE pathogen were consistently associated with long-term prognosis. This information may help in the discussion of individual prognosis and clinical decision-making.
journal_name
BMC Infect Disjournal_title
BMC infectious diseasesauthors
Francisco J,Aragão I,Cardoso Tdoi
10.1186/s12879-018-3054-4subject
Has Abstractpub_date
2018-04-05 00:00:00pages
161issue
1issn
1471-2334pii
10.1186/s12879-018-3054-4journal_volume
18pub_type
杂志文章abstract:BACKGROUND:Pulmonary nocardiosis frequently occurs in immunocompromised hosts and in some immunocompetent hosts with chronic lung disease; however, few reports have described pulmonary nocardiosis with nontuberculous mycobacterial lung infection. Here we report for the first time two cases of pulmonary nocardiosis caus...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-014-0684-z
更新日期:2014-12-10 00:00:00
abstract:BACKGROUND:Acinetobacter species are associated with increasing mortality due to emerging drug-resistance. Pediatric Acinetobacter infections are largely undefined in developed countries and clinical laboratory identification methods do not reliably differentiate between members of the Acinetobacter calcoaceticus-bauma...
journal_title:BMC infectious diseases
pub_type: 杂志文章
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更新日期:2016-07-22 00:00:00
abstract:BACKGROUND:Clostridium difficile infection (CDI), a complication of antibiotic-induced injury to the gut microbiome, is a prevalent and dangerous cause of infectious diarrhea. Antimicrobial therapy for CDI is typically effective for acute symptoms, but up to one third of patients later experience recurrent CDI. Fecal-d...
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更新日期:2015-04-17 00:00:00
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journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-13-413
更新日期:2013-09-03 00:00:00
abstract:BACKGROUND:HIV controllers (HICs) are a rare group of HIV-1-infected individuals able to naturally control viral replication. Several studies have identified the occurrence of HIV dual infections in seropositive individuals leading to disease progression. In HICs, however, dual infections with divergent outcomes in pat...
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pub_type: 杂志文章
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更新日期:2013-04-18 00:00:00
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journal_title:BMC infectious diseases
pub_type: 杂志文章
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更新日期:2014-07-03 00:00:00
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journal_title:BMC infectious diseases
pub_type: 杂志文章
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更新日期:2013-07-28 00:00:00
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pub_type: 杂志文章
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更新日期:2018-12-03 00:00:00
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journal_title:BMC infectious diseases
pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1186/s12879-017-2841-7
更新日期:2017-12-05 00:00:00
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journal_title:BMC infectious diseases
pub_type: 杂志文章,评审
doi:10.1186/s12879-020-05480-y
更新日期:2020-10-19 00:00:00
abstract:BACKGROUND:Microscopic examination of peripheral blood smear produces reliable results both about the malaria infection status and level of parasitemia. However, test results are affected by skill of the laboratory personnel, workload, condition of microscopes and quality of laboratory supplies. Therefore, continuous m...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-020-05077-5
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journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-9-110
更新日期:2009-07-11 00:00:00
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journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-015-0847-6
更新日期:2015-02-26 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12879-019-3804-y
更新日期:2019-02-14 00:00:00
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journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-018-3263-x
更新日期:2018-07-31 00:00:00
abstract::After publication of the original article [1], we were notified that two of the author names were incorrectly displayed in the pdf version of the paper, while one other name was incorrectly tagged in the XML version. ...
journal_title:BMC infectious diseases
pub_type: 已发布勘误
doi:10.1186/s12879-019-4003-6
更新日期:2019-05-27 00:00:00
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journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-6-65
更新日期:2006-03-30 00:00:00
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pub_type: 杂志文章
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更新日期:2007-04-18 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12879-019-4044-x
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更新日期:2016-03-24 00:00:00
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journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-12-285
更新日期:2012-11-02 00:00:00
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journal_title:BMC infectious diseases
pub_type: 杂志文章
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更新日期:2013-02-05 00:00:00
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journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-020-05233-x
更新日期:2020-07-14 00:00:00
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journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-020-05316-9
更新日期:2020-08-05 00:00:00
abstract:BACKGROUND:This epidemiological study was carried out in Sfax (south of Tunisia) and focused on genital Chlamydia trachomatis (C. trachomatis) genovar distribution. METHODS:One hundred and thirty seven genital samples from 4067 patients (4.2%) attending the Habib Bourguiba University hospital of Sfax over 12 years (fr...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-12-333
更新日期:2012-11-30 00:00:00
abstract:BACKGROUND:Human immunodeficiency virus (HIV)-associated tuberculosis deaths have decreased worldwide over the past decade. We sought to evaluate the effect of HIV status on tuberculosis mortality among patients undergoing treatment for tuberculosis in Lima, Peru, a low HIV prevalence setting. METHODS:We conducted a p...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-016-1375-8
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Azithromycin has been widely used for Mycoplasma genitalium treatment internationally. However, the eradication efficacy has substantially declined recent decade. In Russia, josamycin (another macrolide) is the recommended first-line treatment for M. genitalium infections, however, no data regarding treatmen...
journal_title:BMC infectious diseases
pub_type: 杂志文章
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更新日期:2015-02-03 00:00:00
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journal_title:BMC infectious diseases
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doi:10.1186/s12879-015-1144-0
更新日期:2015-10-13 00:00:00