{Reference Type}: Journal Article {Title}: Non-fermentative gram-negative bloodstream infection in northern Italy: a multicenter cohort study. {Author}: Pascale R;Corcione S;Bussini L;Pancaldi L;Giacobbe DR;Ambretti S;Lupia T;Costa C;Marchese A;De Rosa FG;Bassetti M;Viscoli C;Bartoletti M;Giannella M;Viale P; {Journal}: BMC Infect Dis {Volume}: 21 {Issue}: 1 {Year}: Aug 2021 12 {Factor}: 3.667 {DOI}: 10.1186/s12879-021-06496-8 {Abstract}: 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.