The exploration of risk factors of concurrent bacteraemia in patients critically ill with severe dengue

Chin Ming Chen, Khee Siang Chan, Kuo Chen Cheng, Willy Chou, Hui Chun Chao, Chiu Yin Yeh, Wen Liang Yu

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

We investigated the clinical features of intensive care unit (ICU) patients with concomitant severe dengue infection and bacteraemia to identify risk factors for this comorbidity. The records of all ICU dengue patients admitted during the period of 31 July-30 November 2015 were reviewed. Patients with 'concurrent bacteremia' (positive bacterial blood culture within 72 h of ICU admission) were identified. ICU admission was required for 142 patients, of which 22 (15.5%) had concurrent bacteraemia. Species of the genus Streptococcus was the most common pathogens, followed by Escherichia coli then species of the genus Staphylococcus. Patients with a severe dengue infection and bacteraemia had higher APACHE II and TISS scores, C-reactive protein (CRP) levels and leukocyte counts, positive fluid balances, longer activated partial thromboplastin times (APTTs), higher lactate levels and more kidney failure, but controls (severe dengue patients without bacteraemia) had higher Glasgow Coma Scale (GCS) scores, higher albumin levels and more abdominal pain (all P<0.05). Patients with bacteraemia had a higher mortality rate than did ontrols (40.9 vs 18.3%; P=0.018). Multiple logistic regression analysis showed that bacteraemia was significantly positively associated with the following independent predictors: Higher CRP levels [adjusted odds ratio (aOR): 1.026; 95% confidence interval (CI): 1.008-1.044; P=0.005], and longer APTTs (aOR: 1.034; 95 CI: 1.004-1.065; P=0.027). Concurrent bacteraemia is not uncommon in severe dengue patients in the ICU, and it is associated with high mortality. Higher CRP levels and longer APTTs were two independent risk factors associated with bacteraemia.

Original languageEnglish
Article number000388
Pages (from-to)1505-1511
Number of pages7
JournalJournal of Medical Microbiology
Volume65
Issue number12
DOIs
Publication statusPublished - Dec 1 2016

Fingerprint

Severe Dengue
Bacteremia
Critical Illness
Intensive Care Units
Partial Thromboplastin Time
C-Reactive Protein
Odds Ratio
Confidence Intervals
Glasgow Coma Scale
APACHE
Water-Electrolyte Balance
Dengue
Mortality
Infection
Streptococcus
Staphylococcus
Leukocyte Count
Abdominal Pain
Renal Insufficiency
Comorbidity

ASJC Scopus subject areas

  • Microbiology
  • Microbiology (medical)

Cite this

The exploration of risk factors of concurrent bacteraemia in patients critically ill with severe dengue. / Chen, Chin Ming; Chan, Khee Siang; Cheng, Kuo Chen; Chou, Willy; Chao, Hui Chun; Yeh, Chiu Yin; Yu, Wen Liang.

In: Journal of Medical Microbiology, Vol. 65, No. 12, 000388, 01.12.2016, p. 1505-1511.

Research output: Contribution to journalArticle

Chen, Chin Ming ; Chan, Khee Siang ; Cheng, Kuo Chen ; Chou, Willy ; Chao, Hui Chun ; Yeh, Chiu Yin ; Yu, Wen Liang. / The exploration of risk factors of concurrent bacteraemia in patients critically ill with severe dengue. In: Journal of Medical Microbiology. 2016 ; Vol. 65, No. 12. pp. 1505-1511.
@article{814a5cc5b60b43f79dd64081d1da52da,
title = "The exploration of risk factors of concurrent bacteraemia in patients critically ill with severe dengue",
abstract = "We investigated the clinical features of intensive care unit (ICU) patients with concomitant severe dengue infection and bacteraemia to identify risk factors for this comorbidity. The records of all ICU dengue patients admitted during the period of 31 July-30 November 2015 were reviewed. Patients with 'concurrent bacteremia' (positive bacterial blood culture within 72 h of ICU admission) were identified. ICU admission was required for 142 patients, of which 22 (15.5{\%}) had concurrent bacteraemia. Species of the genus Streptococcus was the most common pathogens, followed by Escherichia coli then species of the genus Staphylococcus. Patients with a severe dengue infection and bacteraemia had higher APACHE II and TISS scores, C-reactive protein (CRP) levels and leukocyte counts, positive fluid balances, longer activated partial thromboplastin times (APTTs), higher lactate levels and more kidney failure, but controls (severe dengue patients without bacteraemia) had higher Glasgow Coma Scale (GCS) scores, higher albumin levels and more abdominal pain (all P<0.05). Patients with bacteraemia had a higher mortality rate than did ontrols (40.9 vs 18.3{\%}; P=0.018). Multiple logistic regression analysis showed that bacteraemia was significantly positively associated with the following independent predictors: Higher CRP levels [adjusted odds ratio (aOR): 1.026; 95{\%} confidence interval (CI): 1.008-1.044; P=0.005], and longer APTTs (aOR: 1.034; 95 CI: 1.004-1.065; P=0.027). Concurrent bacteraemia is not uncommon in severe dengue patients in the ICU, and it is associated with high mortality. Higher CRP levels and longer APTTs were two independent risk factors associated with bacteraemia.",
author = "Chen, {Chin Ming} and Chan, {Khee Siang} and Cheng, {Kuo Chen} and Willy Chou and Chao, {Hui Chun} and Yeh, {Chiu Yin} and Yu, {Wen Liang}",
year = "2016",
month = "12",
day = "1",
doi = "10.1099/jmm.0.000388",
language = "English",
volume = "65",
pages = "1505--1511",
journal = "Journal of Medical Microbiology",
issn = "0022-2615",
publisher = "Society for General Microbiology",
number = "12",

}

TY - JOUR

T1 - The exploration of risk factors of concurrent bacteraemia in patients critically ill with severe dengue

AU - Chen, Chin Ming

AU - Chan, Khee Siang

AU - Cheng, Kuo Chen

AU - Chou, Willy

AU - Chao, Hui Chun

AU - Yeh, Chiu Yin

AU - Yu, Wen Liang

PY - 2016/12/1

Y1 - 2016/12/1

N2 - We investigated the clinical features of intensive care unit (ICU) patients with concomitant severe dengue infection and bacteraemia to identify risk factors for this comorbidity. The records of all ICU dengue patients admitted during the period of 31 July-30 November 2015 were reviewed. Patients with 'concurrent bacteremia' (positive bacterial blood culture within 72 h of ICU admission) were identified. ICU admission was required for 142 patients, of which 22 (15.5%) had concurrent bacteraemia. Species of the genus Streptococcus was the most common pathogens, followed by Escherichia coli then species of the genus Staphylococcus. Patients with a severe dengue infection and bacteraemia had higher APACHE II and TISS scores, C-reactive protein (CRP) levels and leukocyte counts, positive fluid balances, longer activated partial thromboplastin times (APTTs), higher lactate levels and more kidney failure, but controls (severe dengue patients without bacteraemia) had higher Glasgow Coma Scale (GCS) scores, higher albumin levels and more abdominal pain (all P<0.05). Patients with bacteraemia had a higher mortality rate than did ontrols (40.9 vs 18.3%; P=0.018). Multiple logistic regression analysis showed that bacteraemia was significantly positively associated with the following independent predictors: Higher CRP levels [adjusted odds ratio (aOR): 1.026; 95% confidence interval (CI): 1.008-1.044; P=0.005], and longer APTTs (aOR: 1.034; 95 CI: 1.004-1.065; P=0.027). Concurrent bacteraemia is not uncommon in severe dengue patients in the ICU, and it is associated with high mortality. Higher CRP levels and longer APTTs were two independent risk factors associated with bacteraemia.

AB - We investigated the clinical features of intensive care unit (ICU) patients with concomitant severe dengue infection and bacteraemia to identify risk factors for this comorbidity. The records of all ICU dengue patients admitted during the period of 31 July-30 November 2015 were reviewed. Patients with 'concurrent bacteremia' (positive bacterial blood culture within 72 h of ICU admission) were identified. ICU admission was required for 142 patients, of which 22 (15.5%) had concurrent bacteraemia. Species of the genus Streptococcus was the most common pathogens, followed by Escherichia coli then species of the genus Staphylococcus. Patients with a severe dengue infection and bacteraemia had higher APACHE II and TISS scores, C-reactive protein (CRP) levels and leukocyte counts, positive fluid balances, longer activated partial thromboplastin times (APTTs), higher lactate levels and more kidney failure, but controls (severe dengue patients without bacteraemia) had higher Glasgow Coma Scale (GCS) scores, higher albumin levels and more abdominal pain (all P<0.05). Patients with bacteraemia had a higher mortality rate than did ontrols (40.9 vs 18.3%; P=0.018). Multiple logistic regression analysis showed that bacteraemia was significantly positively associated with the following independent predictors: Higher CRP levels [adjusted odds ratio (aOR): 1.026; 95% confidence interval (CI): 1.008-1.044; P=0.005], and longer APTTs (aOR: 1.034; 95 CI: 1.004-1.065; P=0.027). Concurrent bacteraemia is not uncommon in severe dengue patients in the ICU, and it is associated with high mortality. Higher CRP levels and longer APTTs were two independent risk factors associated with bacteraemia.

UR - http://www.scopus.com/inward/record.url?scp=85007403558&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85007403558&partnerID=8YFLogxK

U2 - 10.1099/jmm.0.000388

DO - 10.1099/jmm.0.000388

M3 - Article

C2 - 27902388

AN - SCOPUS:85007403558

VL - 65

SP - 1505

EP - 1511

JO - Journal of Medical Microbiology

JF - Journal of Medical Microbiology

SN - 0022-2615

IS - 12

M1 - 000388

ER -