Carbapenem-resistant Gram-negative pathogens associated with septic shock: a review of 120 cases

J Chemother. 2022 Nov;34(7):436-445. doi: 10.1080/1120009X.2022.2064703. Epub 2022 Apr 21.

Abstract

This study aimed to evaluate the influencing variables for outcomes in patients with septic shock having culture-proven carbapenem-resistant Gram-negative pathogens. It included 120 patients (mean age 64.29 ± 1.35 years and 58.3% female). The mean Sequential Organ Failure Assessment score during septic shock diagnosis was found to be 11.22 ± 0.43 and 9 ± 0.79 among the patients with mortality and among the survivors, respectively (P = 0.017). The logistic regression analysis showed that empirical treatment as mono Gram-negative bacteria-oriented antibiotic therapy (P = 0.016, odds ratio (OR) = 17.730, 95% confidence interval (CI): 1.728-182.691), Charlson Comorbidity Index >2 (P = 0.032, OR = 7.312, 95% CI: 5.7-18.3), and systemic inflammatory response syndrome score 3 or 4 during septic shock diagnosis (P = 0.014, OR = 5.675, 95% CI: 1.424-22.619) were found as independent risk factors for day 30 mortality. Despite early diagnosis and effective management of patients with septic shock, the mortality rates are quite high in CRGNP-infected patients.

Keywords: Carbapenem resistance; Gram-negative pathogens; septic shock.

Publication types

  • Review

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Carbapenems / therapeutic use
  • Female
  • Gram-Negative Bacteria
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sepsis* / drug therapy
  • Shock, Septic* / drug therapy

Substances

  • Carbapenems
  • Anti-Bacterial Agents