Kerimoglu Elif, Catak Tuba, Kilinc Anil
Department of Intensive Care, Ordu Training and Research Hospital, Ordu 52200, Türkiye.
Department of Anesthesiology and Reanimation, Faculty of Dentistry, Necmettin Erbakan University, Konya 42090, Türkiye.
Antibiotics (Basel). 2025 Jul 12;14(7):700. doi: 10.3390/antibiotics14070700.
Carbapenem-resistant Gram-negative bacteria (CR-GNB) infections in intensive care units (ICUs) are increasingly prevalent and associated with high mortality. This study aimed to investigate the distribution of isolated bacteria and determine the factors associated with mortality among ICU patients diagnosed with CR-GNB infections. This retrospective study included 95 patients admitted to the ICU between February 2022 and July 2024 who were diagnosed with CR-GNB infections via culture and initiated on treatment. Thirty-day mortality was defined as the clinical outcome, and patients were divided into two groups: survivors (Group 1, = 42) and deceased (Group 2, = 53). Demographic, clinical, laboratory, and microbiological data were analyzed. Advanced age, the presence of malignancy, an elevated Charlson Comorbidity Index (CCI), lower platelet counts, and higher C-reactive protein (CRP) levels were significantly associated with mortality ( < 0.05). Trauma-related admissions were more common among survivors, while sepsis-related admissions predominated among non-survivors. No statistically significant associations were observed between antibiotic regimen type and mortality. Culture-based pathogen distribution revealed as the predominant organism in respiratory samples, while was more frequently isolated from bloodstream and urinary specimens. Mortality in ICU patients with CR-GNB infections is influenced by both baseline comorbidities and infection-related inflammatory markers. This study provides region-specific insights from a high-resistance ICU setting and may inform risk stratification, prognostication, and management strategies in critically ill patients with CR-GNB infections.
重症监护病房(ICU)中耐碳青霉烯类革兰氏阴性菌(CR-GNB)感染日益普遍,且与高死亡率相关。本研究旨在调查分离出的细菌分布情况,并确定诊断为CR-GNB感染的ICU患者中与死亡率相关的因素。这项回顾性研究纳入了2022年2月至2024年7月期间入住ICU且经培养诊断为CR-GNB感染并开始接受治疗的95例患者。将30天死亡率定义为临床结局,患者分为两组:存活者(第1组,n = 42)和死亡者(第2组,n = 53)。对人口统计学、临床、实验室和微生物学数据进行了分析。高龄、存在恶性肿瘤、Charlson合并症指数(CCI)升高、血小板计数较低以及C反应蛋白(CRP)水平较高与死亡率显著相关(P < 0.05)。与创伤相关的入院在存活者中更为常见,而非存活者中与脓毒症相关的入院占主导。未观察到抗生素治疗方案类型与死亡率之间存在统计学显著关联。基于培养的病原体分布显示,[具体细菌名称1]是呼吸道样本中的主要病原体,而[具体细菌名称2]更频繁地从血液和尿液标本中分离出来。CR-GNB感染的ICU患者的死亡率受基线合并症和感染相关炎症标志物两者影响。本研究提供了来自高耐药ICU环境的区域特异性见解,并可能为CR-GNB感染的危重症患者的风险分层、预后评估和管理策略提供参考。