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

研究成果: 雜誌貢獻文章

2 引文 斯高帕斯(Scopus)

摘要

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.

原文英語
文章編號000388
頁(從 - 到)1505-1511
頁數7
期刊Journal of Medical Microbiology
65
發行號12
DOIs
出版狀態已發佈 - 十二月 1 2016

    指紋

ASJC Scopus subject areas

  • Microbiology
  • Microbiology (medical)

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