%0 Journal Article %T Non-fermentative gram-negative bloodstream infection in northern Italy: a multicenter cohort study. %A Pascale R %A Corcione S %A Bussini L %A Pancaldi L %A Giacobbe DR %A Ambretti S %A Lupia T %A Costa C %A Marchese A %A De Rosa FG %A Bassetti M %A Viscoli C %A Bartoletti M %A Giannella M %A Viale P %J BMC Infect Dis %V 21 %N 1 %D Aug 2021 12 %M 34384380 %F 3.667 %R 10.1186/s12879-021-06496-8 %X BACKGROUND: The management of non-fermentative gram-negative bloodstream infection (NFGN-BSI) offers numerous challenges. In this study the aim is to analyse a large cohort of patients with NFGN-BSI recruited in the northern Italy to describe epidemiology, etiological and susceptibility pattern, therapeutic management and outcome.
METHODS: Multicentre retrospective cohort study of patients hospitalised at three large teaching hospitals in northern Italy in a fourth year period.
RESULTS: 355 BSI episodes were analyzed, due to P. aeruginosa (72.7%), A. baumannii (16.6%), and Stenotrophomonas maltophilia (10.7%). Overall, 21.4% of isolates were defined as DTR, highest rate among A. baumannii (64.4%). All-cause 30-day mortality rate was 17.5%. Rates of XDR or DTR A. baumannii isolation were significantly higher in non-surviving patients. Independent risk factors for 30-day mortality were: age (HR 1.03, 95%CI 1.00-1.04, p = 0.003), septic shock (HR 2.84, 95%CI 1.67-4.82, p < 0.001) and BSI due to Acinetobacter baumannii (HR 2.23, 95%CI 1.27-3.94, p = 0.005).
CONCLUSIONS: The overall prevalence of DTR was high in the NFGN BSI cohort analyzied, mainly among Acinetobacter baumannii episodes (64.4%). Acinetobacter baumannii is showed to be an independent predictor of mortality. These evidences marked the urgent need of new therapeutic options against this pathogen.
BACKGROUND: 79/2017/O/OssN. Approved: March14th, 2017.