Predictors of Mortality of Streptococcal Bacteremia and the Role of Infectious Diseases Consultation: A Retrospective Cohort Study.

Détails

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Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_FBE241ACE9B2
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Predictors of Mortality of Streptococcal Bacteremia and the Role of Infectious Diseases Consultation: A Retrospective Cohort Study.
Périodique
Clinical infectious diseases
Auteur⸱e⸱s
Fourre N., Zimmermann V., Senn L., Aruanno M., Guery B., Papadimitriou-Olivgeris M.
ISSN
1537-6591 (Electronic)
ISSN-L
1058-4838
Statut éditorial
Publié
Date de publication
14/06/2024
Peer-reviewed
Oui
Volume
78
Numéro
6
Pages
1544-1550
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Streptococcal bacteremia is associated with high mortality. Thia study aims to identify predictors of mortality among patients with streptococcal bacteremia.
This retrospective study was conducted at the Lausanne University Hospital, Switzerland, and included episodes of streptococcal bacteremia among adult patients from 2015 to 2023.
During the study period, 861 episodes of streptococcal bacteremia were included. The majority of episodes were categorized in the Mitis group (348 episodes; 40%), followed by the Pyogenic group (215; 25%). Endocarditis was the most common source of bacteremia (164; 19%). The overall 14-day mortality rate was 8% (65 episodes). The results from the Cox multivariable regression model showed that a Charlson comorbidity index >4 (P .001; hazard ratio [HR], 2.87; confidence interval [CI]: 1.58-5.22), Streptococcus pyogenes (P = .011; HR, 2.54;CI: 1.24-5.21), sepsis (P < .001; HR, 7.48; CI: 3.86-14.47), lower respiratory tract infection (P = .002; HR, 2.62; CI: 1.42-4.81), and absence of source control interventions within 48 hours despite being warranted (P = .002; HR, 2.62; CI: 1.43-4.80) were associated with 14-day mortality. Conversely, interventions performed within 48 hours of bacteremia onset, such as infectious diseases consultation (P < .001; HR, 0.29; CI: .17-.48) and appropriate antimicrobial treatment (P < .001; HR, .28; CI: .14-.57), were associated with improved outcome.
Our findings underscore the pivotal role of infectious diseases consultation in guiding antimicrobial treatment and recommending source control interventions for patients with streptococcal bacteremia.
Mots-clé
Humans, Streptococcal Infections/mortality, Streptococcal Infections/microbiology, Retrospective Studies, Bacteremia/mortality, Bacteremia/microbiology, Male, Female, Middle Aged, Aged, Switzerland/epidemiology, Referral and Consultation, Adult, Risk Factors, Streptococcus pyogenes, Aged, 80 and over, bloodstream infection, infectious diseases consultation, sepsis, source control, streptococci
Pubmed
Web of science
Open Access
Oui
Création de la notice
02/04/2024 9:41
Dernière modification de la notice
18/06/2024 7:23
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