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

doi:10.1099/jmm.0.000388

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標題:	The exploration of risk factors of concurrent bacteraemia in patients critically ill with severe dengue
作者:	Chen, Chin-Ming Chan, Khee-Siang Cheng, Kuo-Chen Chou, Willy Chao, Hui-Chun Yeh, Chiu-Yin Yu, Wen-Liang
貢獻者:	Chia Nan Univ Pharm & Sci, Dept Recreat & Hlth Care Management Chi Mei Med Ctr, Dept Intens Care Med Chi Mei Med Ctr, Dept Internal Med Chung Hwa Univ Med Technol, Dept Safety Hlth & Environm Taipei Med Univ, Dept Med
關鍵字:	singapore fever
日期:	2016-12
上傳時間:	2018-01-18 11:40:47 (UTC+8)
出版者:	Microbiology Soc
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.
關聯:	Journal of Medical Microbiology, v.65, pp.1505-1511
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