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    標題: Bloodstream infections in hospitalized adults with dengue fever: Clinical characteristics and recommended empirical therapy
    作者: Syue, Ling-Shan
    Hung-Jen Tang(湯宏仁)
    Hung, Yuan-Pin
    Chen, Po-Lin
    Li, Chia-Wen
    Li, Ming-Chi
    Tsai, Pei-Fang
    Liu, Ching-Chuan
    Lee, Nan-Yao
    Ko, Wen-Chien
    貢獻者: Natl Cheng Kung Univ Hosp, Dept Internal Med
    Natl Cheng Kung Univ Hosp, Ctr Infect Control
    Chi Mei Med Ctr, Dept Med
    Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr
    Minist Hlth & Welf, Dept Internal Med, Tainan Hosp
    Natl Cheng Kung Univ Hosp, Dept Pathol
    Natl Cheng Kung Univ Hosp, Dept Pediat
    Natl Cheng Kung Univ, Dept Med, Coll Med
    關鍵字: Severe dengue
    Sepsis
    Bacteremia
    Candidemia
    Empirical therapy
    Concurrent infection
    Fatality
    日期: 2019-04
    上傳時間: 2020-07-29 13:53:34 (UTC+8)
    出版者: ELSEVIER TAIWAN
    摘要: Background: Dengue is an important mosquito-borne tropical viral disease and dual infection, though rare, has been regarded as a risk factor for severe disease and mortality. However, few studies focused on bloodstream infections (BSIs) and empirical antibiotic therapy rarely addressed. Methods: Dengue patients with concurrent or subsequent BSIs between July 1 and December 31, 2015 were included. Clinical information, laboratory data, and drug susceptibility data were collected. Results: Totally 80 patients, with an in-hospital mortality rate of 32.5%, were included and categorized into three groups. 32 patients in Group I (BSI onset within 48 h after admission), 32 in Group II (between 48 h and one week), and 16 in Group III (more than one week). Patients in Group I were older (mean age: 75.6 vs. 72.6 or 69.6 years; P = 0.01) and had a higher Charlson comorbidity index (3.1 vs. 1.8 or 1.9; P = 0.02) than those in Group II or III. Streptococcus species (28.9%, 11/38) and Escherichia coli (23.7%, 9/38) were major pathogens in Group I. Enterobacteriaceae (38.2%, 13/34) isolates predominated in Group II. Fatal patients more often received inappropriate empirical antibiotic than the survivors (61.5% vs. 35.2%; P = 0.03). According to susceptibility data, pathogens in Group I and II shared similar susceptibility profiles, and levofloxacin, cefepime, or piperacillin/tazobactam, can be empirically prescribed for those hospitalized within one week. Conclusions: BSI pathogens vary among dengue patients. For adults with dengue and suspected BSI hospitalized within one week, empirical antimicrobial agents are recommended. Copyright (C) 2018, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC.
    關聯: Journal of Microbiology Immunology and Infection, v.52, n.2, pp.225-232
    Appears in Collections:[保健營養系(所) ] 期刊論文

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