التفاصيل البيبلوغرافية
| العنوان: |
Mediastinitis due to Gram-negative bacteria is associated with increased mortality. |
| المؤلفون: |
Charbonneau, H.1,2, Maillet, J. M.1,3, Faron, M.4, Mangin, O.1,2, Puymirat, E.1,2, Le Besnerais, P.3, Du Puy-Montbrun, L.2,5, Achouh, P.2,5, Diehl, J. L.1,2, Fagon, J.-Y.1,2, Mainardi, J.-l.2,6, Guerot, E.1,2 |
| المصدر: |
Clinical Microbiology & Infection. Mar2014, Vol. 20 Issue 3, pO197-O202. 6p. |
| مصطلحات موضوعية: |
*MEDIASTINITIS, *GRAM-negative bacterial diseases, *INTENSIVE care units, *MULTIVARIATE analysis, *ARTIFICIAL respiration, *BACTERIAL disease treatment |
| مستخلص: |
The aim of this study was to describe the features of a large cohort of patients with postoperative mediastinitis, with particular regard to Gram-negative bacteria ( GNB), and assess their outcome. This bicentric retrospective cohort included all patients who were hospitalized in the Intensive Care Unit with mediastinitis after cardiac surgery during a 9-year period. Three hundred and nine patients developed a mediastinitis with a mean age of 65 years and a mean standard Euroscore of six points. Ninety-one patients (29.4%) developed a GNB mediastinitis ( GNBm). Of the 364 pathogens involved, 103 GNB were identified. GNBm were more frequently polymicrobial (44% versus 3.2%; p <0.001). Being female was the sole independent risk factor of GNBm in multivariate analysis. Initial antimicrobial therapy was significantly more frequently inappropriate with GNBm compared with other microorganisms (24.6% versus 1.9%; p <0.001). Independent risk factors for inappropriateness of initial antimicrobial treatment were GNBm ( OR = 8.58, 95% CI 2.53-29.02, p 0.0006), and polymicrobial mediastinitis ( OR = 4.52, 95% CI 1.68-12.12, p 0.0028). GNBm were associated with more drainage failure, secondary infection, need for prolonged mechanical ventilation and/or use of vasopressors. Thirty-day hospital mortality was significantly higher with GNBm (31.9 % versus 17.0%; p 0.004). GNBm was identified as an independent risk factor of hospital mortality ( OR = 2.31, 95% CI 1.16-4.61, p 0.0179). [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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