1.Different Clinical Characteristics Among Aeromonas hydrophila, Aeromonas veronii biovar sobria and Aeromonas caviae Monomicrobial Bacteremia.
Han Chuan CHUANG ; Yu Huai HO ; Chorng Jang LAY ; Lih Shinn WANG ; Yeong Shu TSAI ; Chen Chi TSAI
Journal of Korean Medical Science 2011;26(11):1415-1420
This study aimed to compare the clinical presentations of Aeromonas hydrophila, A. veronii biovar sobria and A. caviae monomicrobial bacteremia by a retrospective method at three hospitals in Taiwan during an 8-yr period. There were 87 patients with A. hydrophila bacteremia, 45 with A. veronii biovar sobria bacteremia and 22 with A. caviae bacteremia. Compared with A. hydrophila and A. veronii biovar sobria bacteremia, A. caviae bacteremia was more healthcare-associated (45 vs 30 and 16%; P = 0.031). The patients with A. caviae bacteremias were less likely to have liver cirrhosis (27 vs 62 and 64%; P = 0.007) and severe complications such as shock (9 vs 40 and 47%; P = 0.009) and thrombocytopenia (45 vs 67 and 87%; P = 0.002). The APACHE II score was the most important risk factor of Aeromonas bacteremia-associated mortalities. The APACHE II scores of A. caviae bacteremias were lower than A. hydrophila bacteremia and A. veronii biovar sobria bacteremia (7 vs 14 and 16 points; P = 0.002). In conclusion, the clinical presentation of A. caviae bacteremia was much different from A. hydrophila and A. veronii biovar sobria bacteremia. The severity and mortality of A. caviae bacteremia were lower than A. hydrophila or A. veronii biovar sobria bacteremia.
APACHE
;
Adult
;
Aeromonas caviae/drug effects/*pathogenicity
;
Aeromonas hydrophila/drug effects/*pathogenicity
;
Aged
;
Aged, 80 and over
;
Bacteremia/complications/drug therapy/*microbiology/mortality
;
Cross Infection/microbiology
;
Female
;
Gram-Negative Bacterial Infections/complications/drug therapy/*microbiology/mortality
;
Humans
;
Liver Cirrhosis/microbiology
;
Male
;
Middle Aged
;
Retrospective Studies
;
Shock, Septic/microbiology
;
Taiwan
;
Thrombocytopenia/complications
;
Young Adult
2.Usefulness of C-Reactive Protein for Evaluating Clinical Outcomes in Cirrhotic Patients with Bacteremia.
Young Eun HA ; Cheol In KANG ; Eun Jeong JOO ; Mi Kyong JOUNG ; Doo Ryeon CHUNG ; Kyong Ran PECK ; Nam Yong LEE ; Jae Hoon SONG
The Korean Journal of Internal Medicine 2011;26(2):195-200
BACKGROUND/AIMS: The purpose of this study was to evaluate the value of initial C-reactive protein (CRP) as a predictor of clinical outcome and to investigate whether follow-up CRP measurement is useful for the prediction of the clinical outcome of bloodstream infections in patients with liver cirrhosis (LC), whose CRP production in response to infection may be attenuated. METHODS: A retrospective, observational study including 202 LC patients with Escherichia coli or Klebsiella pneumoniae bacteremia was conducted to assess the usefulness of serial CRP measurements in predicting clinical outcome in LC patients. The CRP ratio was defined as the ratio of the follow-up CRP level to the initial CRP level. RESULTS: The overall 30-day mortality rate of the study population was 23.8% (48/202). In the multivariate analysis, advanced age (> or = 70 years), healthcare-associated or nosocomial infections, model for end-stage liver disease (MELD) score of > or = 30, and initial body temperature of < 37degrees C were significant factors associated with mortality (all p < 0.05). No association between initial CRP level and mortality was found. In a further analysis including 87 evaluable cases who had repeated CRP measurements at day 4 and/or 5, a CRP ratio of > or = 0.7 was found to be a significant factor associated with mortality (odds ratio, 19.12; 95% confidence interval, 1.32 to 276.86; p = 0.043) after adjusting for other confounding variables. CONCLUSIONS: Initial CRP level did not predict mortality of sepsis in LC patients. However, serial CRP measurements during the first week of antimicrobial therapy may be useful as a prognostic factor for mortality in LC patients.
Adult
;
Age Factors
;
Aged
;
Aged, 80 and over
;
Anti-Infective Agents/therapeutic use
;
Bacteremia/drug therapy/*immunology/microbiology/mortality
;
Biological Markers/blood
;
C-Reactive Protein/*metabolism
;
Chi-Square Distribution
;
Escherichia coli Infections/drug therapy/*immunology/microbiology/mortality
;
Female
;
Humans
;
Klebsiella Infections/drug therapy/*immunology/microbiology/mortality
;
Klebsiella pneumoniae/*isolation & purification
;
Liver Cirrhosis/complications/*immunology/mortality
;
Logistic Models
;
Male
;
Middle Aged
;
Odds Ratio
;
Predictive Value of Tests
;
Republic of Korea
;
Retrospective Studies
;
Risk Assessment
;
Risk Factors
;
Time Factors
;
Treatment Outcome