SEARCHCOHORTinfectious disease, gastroenterology

cohort·infectious disease, gastroenterology, internal medicine, emergency medicine, critical care·PMC10344483

Predictor of gram-negative bacteremia in cirrhotic patients with skin and soft-tissue infections

Medicine · 4 authors, 2 centres

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TL;DR

Multivariate regression identified C-reactive protein (CRP), serum lactate, MELD score, and creatinine as independent predictors of GNB.

Full summary

253 CHARS

Multivariate regression identified C-reactive protein (CRP), serum lactate, MELD score, and creatinine as independent predictors of GNB. Findings suggest these variables may help stratify risk for GNB and inform care decisions for hospitalized patients.

STUDY TYPE

cohort

SPECIALTY

infectious disease

SUMMARISED BY

AI pipeline

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100% · A

ORIGINAL PAPER

PMC10344483

Predictor of gram-negative bacteremia in cirrhotic patients with skin and soft-tissue infections

Medicine

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ABSTRACT

Abstract Cirrhosis always goes with profound immunity compromise, and makes those patients easily be the target of skin and soft-tissue infections (SSTIs). Cirrhotic patients with SSTIs have a dramatically increased mortality. To recognize the risk factors of gram-negative infections are critical for improving survival rate. A retrospective cohort study of hospitalized cirrhotic patients with SSTIs and gram-negative bacteremia (GNB) was conducted in 2 tertiary hospitals in southern Taiwan between March 2015 and January 2020. Another group were matched by controls with non-GNB based on time, demographics and immune status. Data such as infectious location, comorbidities, and laboratory findings were recorded and compared. Receiver operating curve and the area under the curve were used to evaluate its discriminating ability. A total of 186 patients were included, 62 in GNB group and 124 in non-GNB group. Comorbidities that were significant risk factors for gram-negative bacteremia included acute kidney injury. Significant risk factors evident in laboratory evaluations included higher model for end-stage liver disease score, higher serum lactate, higher C-reactive protein and higher creatinine level. This study found acute kidney injury, or those exhibiting hyperlactatemia (>16 mg/dL), high MELD score (>14), high CRP (>50 mg/dL), and high creatinine (>2.0 mg/dL) were risk factors associated with gram-negative bacteremia. Cirrhotic patients with SSTIs with aforementioned risk factors should pay more attention by clinicians due to higher mortality. Keywords: cirrhosis, gram-negative pathogen, mortality, SSTIs

CITATION EXPORT

Hung-Sheng Wang, Cheng-Ting Hsiao, Wen-Chih Fann et al.. Predictor of gram-negative bacteremia in cirrhotic patients with skin and soft-tissue infections. Medicine. (2023). https://doi.org/10.1097/MD.0000000000034075

AUTHORS

4 · 2 CENTRES

Hung-Sheng Wang, Cheng-Ting Hsiao, Wen-Chih Fann, Chia-Peng Chang

a Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
b Department of Medicine, Chang Gung University, Taoyuan, Taiwan.