Abstract：
We aim to evaluate the role of frailty and inflammatory markers in predicting the short-term outcomes after catheter-associated urinary tract infections (CAUTI) and central line-associated bloodstream infections (CLABSI).
Data regarding the patients\' characteristics, isolates on CAUTI and CLABSI, antibiotic susceptibility, frailty (11-point Modified Frailty Index), and inflammatory markers were retrospectively collected. Their impact on the short-term outcomes was assessed using regression modeling response.
One hundred and one patients with CAUTI (n = 71) and CLABSI (n = 30) between January 2018 and December 2019 were included in this study. The pooled incidence rates for CAUTI were 5.50 and for CLABSI 3.58 episodes/1000 catheter-days. We observed 74.7% drug resistance in our CAUTI isolates and 93.3% in CLABSI. In the multivariate analysis, frailty (P = 0.006), neutrophil/lymphocyte ratio (NLR) (P = 0.007) and the presence of sepsis (P = 0.029) were found to be significant predictors of in-hospital mortality in CAUTI. In patients with CLABSI, frailty (P = 0.029) and NLR (P = 0.029) were found significant and along with sepsis (P = 0.069) resulted in a regression model with good accuracy in predicting mortality. The receiver operating characteristic curve showed that 11-point Modified Frailty Index and NLR as well as the regression model significantly predicted mortality with an area under the curve of 86.1%, 81.4%, and 95.4%, respectively, in CAUTI, and 70.9%, 77.8%, and 95.2%, respectively, in CLABSI.
Data regarding the patients\' characteristics, isolates on CAUTI and CLABSI, antibiotic susceptibility, frailty (11-point Modified Frailty Index), and inflammatory markers were retrospectively collected. Their impact on the short-term outcomes was assessed using regression modeling response.
One hundred and one patients with CAUTI (n = 71) and CLABSI (n = 30) between January 2018 and December 2019 were included in this study. The pooled incidence rates for CAUTI were 5.50 and for CLABSI 3.58 episodes/1000 catheter-days. We observed 74.7% drug resistance in our CAUTI isolates and 93.3% in CLABSI. In the multivariate analysis, frailty (P = 0.006), neutrophil/lymphocyte ratio (NLR) (P = 0.007) and the presence of sepsis (P = 0.029) were found to be significant predictors of in-hospital mortality in CAUTI. In patients with CLABSI, frailty (P = 0.029) and NLR (P = 0.029) were found significant and along with sepsis (P = 0.069) resulted in a regression model with good accuracy in predicting mortality. The receiver operating characteristic curve showed that 11-point Modified Frailty Index and NLR as well as the regression model significantly predicted mortality with an area under the curve of 86.1%, 81.4%, and 95.4%, respectively, in CAUTI, and 70.9%, 77.8%, and 95.2%, respectively, in CLABSI.
摘要：
我们旨在评估虚弱和炎症标志物在预测导管相关尿路感染（CAUTI）和中线相关血流感染（CLABSI）后短期预后中的作用。
有关患者特征的数据，CAUTI和CLABSI上的分离株，抗生素敏感性，脆弱（11点修正脆弱指数），回顾性收集炎症标志物。它们对短期结果的影响使用回归模型响应进行评估。
本研究纳入了2018年1月至2019年12月的101例CAUTI（n=71）和CLABSI（n=30）患者。CAUTI的合并发生率为5.50，CLABSI的合并发生率为3.58发作/1000导管天。我们在CAUTI分离株中观察到74.7%的耐药性，在CLABSI中观察到93.3%的耐药性。在多变量分析中，虚弱（P=0.006），中性粒细胞/淋巴细胞比值(NLR)(P=0.007)和脓毒症(P=0.029)是CAUTI患者住院死亡率的显著预测因子.在CLABSI患者中，衰弱(P=0.029)和NLR(P=0.029)与脓毒症(P=0.069)形成了一个预测死亡率准确性较好的回归模型。受试者工作特征曲线显示，11点修正脆弱指数和NLR以及回归模型显着预测死亡率，曲线下面积为86.1％。81.4%,和95.4%，分别,在CAUTI,70.9%，77.8%,和95.2％，分别,在CLABSI。
有关患者特征的数据，CAUTI和CLABSI上的分离株，抗生素敏感性，脆弱（11点修正脆弱指数），回顾性收集炎症标志物。它们对短期结果的影响使用回归模型响应进行评估。
本研究纳入了2018年1月至2019年12月的101例CAUTI（n=71）和CLABSI（n=30）患者。CAUTI的合并发生率为5.50，CLABSI的合并发生率为3.58发作/1000导管天。我们在CAUTI分离株中观察到74.7%的耐药性，在CLABSI中观察到93.3%的耐药性。在多变量分析中，虚弱（P=0.006），中性粒细胞/淋巴细胞比值(NLR)(P=0.007)和脓毒症(P=0.029)是CAUTI患者住院死亡率的显著预测因子.在CLABSI患者中，衰弱(P=0.029)和NLR(P=0.029)与脓毒症(P=0.069)形成了一个预测死亡率准确性较好的回归模型。受试者工作特征曲线显示，11点修正脆弱指数和NLR以及回归模型显着预测死亡率，曲线下面积为86.1％。81.4%,和95.4%，分别,在CAUTI,70.9%，77.8%,和95.2％，分别,在CLABSI。
