The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting
Abstract
Study objective To evaluate the relationship between the adequacy of antimicrobial treatment for bloodstream infections and clinical outcomes among patients requiring ICU admission.Design Prospective cohort study.Setting A medical ICU (19 beds) and a surgical ICU (18 beds) from a university-affiliated urban teaching hospital.Patients Between July 1997 and July 1999, 492 patients were prospectively evaluated.Intervention Prospective patient surveillance and data collection.Results One hundred forty-seven patients (29.9%) received inadequate antimicrobial treatment for their bloodstream infections. The hospital mortality rate of patients with a bloodstream infection receiving inadequate antimicrobial treatment (61.9%) was statistically greater than the hospital mortality rate of patients with a bloodstream infection who received adequate antimicrobial treatment (28.4%; relative risk, 2. 18; 95% confidence interval [CI], 1.77 to 2.69; p < 0.001). Multiple logistic regression analysis identified the administration of inadequate antimicrobial treatment as an independent determinant of hospital mortality (adjusted odds ratio [AOR], 6.86; 95% CI, 5.09 to 9.24; p < 0.001). The most commonly identified bloodstream pathogens and their associated rates of inadequate antimicrobial treatment included vancomycin-resistant enterococci (n = 17; 100%), Candida species (n = 41; 95.1%), oxacillin-resistant Staphylococcus aureus (n = 46; 32.6%), coagulase-negative staphylococci (n = 96; 21.9%), and Pseudomonas aeruginosa (n = 22; 10.0%). A statistically significant relationship was found between the rates of inadequate antimicrobial treatment for individual microorganisms and their associated rates of hospital mortality (Spearman correlation coefficient = 0.8287; p = 0.006). Multiple logistic regression analysis also demonstrated that a bloodstream infection attributed to Candida species (AOR, 51.86; 95% CI, 24.57 to 109.49; p < 0.001), prior administration of antibiotics during the same hospitalization (AOR, 2.08; 95% CI, 1.58 to 2.74; p = 0.008), decreasing serum albumin concentrations (1-g/dL decrements) (AOR, 1.37; 95% CI, 1.21 to 1.56; p = 0.014), and increasing central catheter duration (1-day increments) (AOR, 1.03; 95% CI, 1.02 to 1.04; p = 0.008) were independently associated with the administration of inadequate antimicrobial treatment.Conclusions The administration of inadequate antimicrobial treatment to critically ill patients with bloodstream infections is associated with a greater hospital mortality compared with adequate antimicrobial treatment of bloodstream infections. These data suggest that clinical efforts should be aimed at reducing the administration of inadequate antimicrobial treatment to hospitalized patients with bloodstream infections, especially individuals infected with antibiotic-resistant bacteria and Candida species.
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Prompt identification of invasive candidiasis through risk factor analysis and diagnostic assays is a key factor affecting sepsis-related mortality.
“The importance of prompt identification of IC through a combination of risk factor analysis and diagnostic assays has been demonstrated to be a key factor affecting sepsis-related mortality.[32][33][34][35][36][37][38][39][40][41]”
From Fungal Sepsis: Optimizing Antifungal Therapy in the Critical Care Setting (2011) · cites this paper as [33]
In an early intensive care unit study, adequate antimicrobial therapy defined by in vitro susceptibility testing was associated with 33% lower mortality.
“One of the earliest studies to examine the effect of appropriate antimicrobial therapy in the ICU observed a 33% lower mortality in patients receiving adequate therapy defined by in vitro antimicrobial susceptibility testing.33”
From Fungal Sepsis: Optimizing Antifungal Therapy in the Critical Care Setting (2011) · cites this paper as [33]
Patients with invasive candidiasis have excessive rates of inappropriate initial therapy and higher mortality than intensive care unit patients with bacterial infections.
“Studies on patients with IC have similarly shown excessive rates of inappropriate initial therapy and even higher mortality than infections caused by bacterial pathogens in the ICU setting.10,14,33,34,[42][43][44][45][46][47]”
From Fungal Sepsis: Optimizing Antifungal Therapy in the Critical Care Setting (2011) · cites this paper as [33]
Inappropriate treatment was most common for Enterococcus species, but inadequate coverage for invasive candidiasis was the second most common error and was associated with the highest mortality.
“Inappropriate treatment was most common for Enterococcus spp; however, inadequate coverage for IC was the second most common error and was associated with the highest mortality.”
From Fungal Sepsis: Optimizing Antifungal Therapy in the Critical Care Setting (2011) · cites this paper as [33]
The highest rates of candidemia in infants less than 1 year of age and in adults over 65 years have been reported from two U.S. studies.
“The highest rates of candidemia in infants less than 1 year of age and in adults over the age of 65 have been reported from the two U.S. studies (92, 113).”
From Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem (2007) · cites this paper as [113]
Active population-based laboratory surveillance design provides information on disease incidence and trends in both the population as a whole and specific risk groups.
“This active population-based laboratory surveillance design provides information on disease incidence and trends in both the population as a whole and specific risk groups (92, 113, 200, 242).”
From Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem (2007) · cites this paper as [113]
The annual average incidence of candidemia in the San Francisco and Atlanta metropolitan areas was 8 infections per 100,000 population.
“A detailed description of the epidemiology of candidemia in the San Francisco and Atlanta metropolitan areas was reported by Kao et al. (113) and established an annual average incidence of candidemia of 8 infections per 100,000 population (Table 5).”
From Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem (2007) · cites this paper as [113]
Population-based studies in San Francisco, CA, Atlanta, GA, Iowa, and Connecticut report lower annual incidence rates of invasive candidiasis, 6 to 8.7 per 100,000.
“By comparison, population-based studies in the San Francisco, CA, and Atlanta, GA, metropolitan areas and in the states of Iowa and Connecticut report lower annual incidence rates of 6 to 8.7 per 100,000 (discussed in greater detail below) (57, 92, 113).”
From Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem (2007) · cites this paper as [113]
The discrepancy between rates of candidemia in black and white infants may be due in part to the elevated incidence of prematurity and low birth weight among black infants.
“The discrepancy between rates of infection in black and white infants may be due in part to the elevated incidence of prematurity and low birth weight among black infants (92, 113).”
From Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem (2007) · cites this paper as [113]
In U.S. studies, 20% to 30% of patients with candidemia were outpatients at diagnosis.
“Indeed, 20% to 30% of patients in the U.S. studies were outpatients at the time of diagnosis (92, 113).”
From Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem (2007) · cites this paper as [113]
Candidemia is no longer associated exclusively with the ICU, as fewer than 40% of patients in most studies were in an ICU at diagnosis.
“These studies also demonstrate that candidemia is no longer associated exclusively with the ICU, as fewer than 40% of patients in most studies were in an ICU at the time of diagnosis (5, 92, 113).”
From Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem (2007) · cites this paper as [113]
Population-based surveillance studies documented a high incidence of candidemia among cancer patients (71 per 100,000).
“Population-based surveillance studies have also documented a high incidence of candidemia among cancer patients (71 per 100,000) and adults with diabetes (28 per 100,000), as well as the near universality of central venous catheters among patients diagnosed with candidemia (5, 92, 113).”
From Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem (2007) · cites this paper as [113]
Population-based surveillance studies documented a high incidence of candidemia among adults with diabetes (28 per 100,000).
“Population-based surveillance studies have also documented a high incidence of candidemia among cancer patients (71 per 100,000) and adults with diabetes (28 per 100,000), as well as the near universality of central venous catheters among patients diagnosed with candidemia (5, 92, 113).”
From Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem (2007) · cites this paper as [113]
In virtually every U.S.-based survey, C. glabrata ranks second to C. albicans as a cause of BSI, accounting for 20% to 24% of all Candida BSIs.
“and virtually every U.S.-based survey has shown C. glabrata to rank second to C. albicans as a cause of BSI, accounting for 20% to 24% of all Candida BSIs (Table 8) (57, 92, 113, 145, 146, 183, 188, 205, 207-209, 212, 216, 220, 224, 292).”
From Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem (2007) · cites this paper as [113]
Central venous catheters are nearly universal among patients diagnosed with candidemia.
“Population-based surveillance studies have also documented a high incidence of candidemia among cancer patients (71 per 100,000) and adults with diabetes (28 per 100,000), as well as the near universality of central venous catheters among patients diagnosed with candidemia (5, 92, 113).”
From Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem (2007) · cites this paper as [113]
Kao et al. found candidemia due to C. guilliermondii to be common among patients with prior cardiovascular or abdominal surgery.
“however, Kao et al. (113) found candidemia due to this species to be common among patients with prior cardiovascular or abdominal surgery.”
From Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem (2007) · cites this paper as [113]
Application of Etest agar-based technology to determine amphotericin B MICs in a broad antifungal surveillance program has identified specific differences in the susceptibilities of the various species of Candida to amphotericin B.
“Application of the Etest agar-based technology to determine amphotericin B MICs in the context of a broad antifungal surveillance program has identified specific differences in the susceptibilities of the various species of Candida to this former 'gold standard' antifungal agent (Table 10) (20, 92, 113, 136, 202, 207, 212, 215, 323).”
From Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem (2007) · cites this paper as [113]
Both C. glabrata and C. krusei exhibit decreased susceptibility to amphotericin B compared with C. albicans.
“Although very little temporal or geographic variation in the susceptibility of Candida species to amphotericin B has been observed, it is evident that both C. glabrata and C. krusei exhibit decreased susceptibility to amphotericin B compared with C. albicans (Table 10) (113, 120, 202, 215, 216, 323).”
From Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem (2007) · cites this paper as [113]
Very little temporal or geographic variation in the susceptibility of Candida species to amphotericin B has been observed.
“Although very little temporal or geographic variation in the susceptibility of Candida species to amphotericin B has been observed, it is evident that both C. glabrata and C. krusei exhibit decreased susceptibility to amphotericin B compared with C. albicans (Table 10) (113, 120, 202, 215, 216, 323).”
From Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem (2007) · cites this paper as [113]
Cites
Bone, R. C., BALK, R. A., Cerra, F. B., Dellinger, R. P., Fein, A. M., Knaus, W. A., Schein, R. M. H., & Sibbald, W. J. (1992) · CHEST Journal · doi:10.1378/chest.101.6.1644 · Cited by 13,192 · see citing works
CDC definitions for nosocomial infections, 1988
Garner, J. S., Jarvis, W. R., Emori, T. G., Horan, T. C., & Hughes, J. M. (1988) · American Journal of Infection Control · doi:10.1016/0196-6553(88)90053-3 · Cited by 5,665 · see citing works
CDC definitions for nosocomial infections
Yangco, B. G. (1989) · American Journal of Infection Control · doi:10.1016/s0196-6553(89)80013-6 · Cited by 3,779 · see citing works
The APACHE III Prognostic System
Knaus, W. A., Wagner, D. P., Draper, E. A., Zimmerman, J. E., Bergner, M., BASTOS, P. G., Sirio, C., Murphy, D. J., Lotring, T., Damiano, A., et al. (1991) · CHEST Journal · doi:10.1378/chest.100.6.1619 · Cited by 3,524 · see citing works
The APACHE III Prognostic System
Teres, D., & Lemeshow, S. A. (1992) · CHEST Journal · doi:10.1378/chest.102.6.1919b · Cited by 2,880 · see citing works
Inadequate Antimicrobial Treatment of Infections
Kollef, M. H., Sherman, G., Ward, S., & Fraser, V. J. (1999) · Chest · doi:10.1378/chest.115.2.462 · Cited by 1,805 · see citing works
Self-citationNosocomial infections in medical intensive care units in the United States
Richards, M. J., Edwards, J. R., Culver, D. H., & Gaynes, R. P. (1999) · Critical Care Medicine · doi:10.1097/00003246-199905000-00020 · Cited by 1,561 · see citing works
Epidemiology of Drug Resistance: Implications for a Post—Antimicrobial Era
Cohen, M. L. (1992) · Science · doi:10.1126/science.257.5073.1050 · Cited by 1,310 · see citing works
Weinstein, M. P., Towns, M., Quartey, S. M., Mirrett, S., Reimer, L. G., Parmigiani, G., & Reller, L. B. (1997) · Clinical Infectious Diseases · doi:10.1093/clind/24.4.584 · Cited by 1,225 · see citing works
The Risk of Determining Risk with Multivariable Models
Concato, J., Feinstein, A. R., & Holford, T. R. (1993) · Annals of Internal Medicine · doi:10.7326/0003-4819-118-3-199302010-00009 · Cited by 1,119 · see citing works
A Computer-Assisted Management Program for Antibiotics and Other Antiinfective Agents
Evans, R. S., Pestotnik, S. L., Classen, D. C., Clemmer, T. P., Weaver, L. K., Orme, J. F., Lloyd, J. F., & Burke, J. P. (1998) · New England Journal of Medicine · doi:10.1056/nejm199801223380406 · Cited by 1,060 · see citing works
Impact of BAL Data on the Therapy and Outcome of Ventilator-Associated Pneumonia
Luna, C. M., Vujacich, P., Niederman, M. S., Vay, C. A., Gherardi, C. R., Matera, J., & Jolly, E. C. (1997) · CHEST Journal · doi:10.1378/chest.111.3.676 · Cited by 915 · see citing works
Enterobacter Bacteremia: Clinical Features and Emergence of Antibiotic Resistance during Therapy
Chow, J. W., Fine, M. J., Shlaes, D. M., Quinn, J. P., Hooper, D. C., Johnson, M. P., Ramphal, R., Wagener, M. M., Miyashiro, D. K., & Yu, V. L. (1991) · Annals of Internal Medicine · doi:10.7326/0003-4819-115-8-585 · Cited by 887 · see citing works
Ventilator-associated Pneumonia Caused by Potentially Drug-resistant Bacteria
Trouillet, J., Chastre, J. E., Vuagnat, A., Joly‐Guillou, M., Combaux, D., Dombret, M.-C., & Gibert, C. (1998) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.157.2.9705064 · Cited by 884 · see citing works
Ventilator-associated pneumonia. A multivariate analysis
Kollef, M. H. (1993) · JAMA · doi:10.1001/jama.270.16.1965 · Cited by 745 · see citing works
Self-citationThe benefit of appropriate empirical antibiotic treatment in patients with bloodstream infection
Leibovici, Shraga, Drucker, Konigsberger, Samra, Pitlik, & Pitlik (1998) · Journal of Internal Medicine · doi:10.1046/j.1365-2796.1998.00379.x · Cited by 685 · see citing works
Álvarez-Lerma, F., & ICU-Acquired Pneumonia Study Group (1996) · Intensive Care Medicine · doi:10.1007/bf01712153 · Cited by 649 · see citing works
Meinert, C. L. (1986) · DigitalGeorgetown (Georgetown University Library) · doi:10.1093/acprof:oso/9780195035681.001.0001 · Cited by 509 · see citing works
The Influence of Mini-BAL Cultures on Patient Outcomes
Kollef, M. H., & Ward, S. (1998) · CHEST Journal · doi:10.1378/chest.113.2.412 · Cited by 498 · see citing works
Self-citationThe Value of Routine Microbial Investigation in Ventilator-Associated Pneumonia
Rello, J., Gallego, M., Mariscal, D., Sonora, R., & Vallés, J. (1997) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.156.1.9607030 · Cited by 467 · see citing works
The Economic Impact of Staphylococcus aureus Infection in New York City Hospitals
Rubin, R. J., Harrington, C. A., Poon, A., Dietrich, K. A., Greene, J. A., & Moiduddin, A. (1999) · Emerging infectious diseases · doi:10.3201/eid0501.990102 · Cited by 444 · see citing works
Health and Economic Impacts of Antimicrobial Resistance
Holmberg, S. D., Solomon, S. L., & Blake, P. A. (1987) · Clinical Infectious Diseases · doi:10.1093/clinids/9.6.1065 · Cited by 418 · see citing works
Health and Economic Outcomes of Antibiotic Resistance in Pseudomonas aeruginosa
Carmeli, Y., Troillet, N., Karchmer, A. W., et al. (1999) · Archives of Internal Medicine · doi:10.1001/archinte.159.10.1127 · Cited by 370 · see citing works
Bryan, C. S., Reynolds, K. L., & BRENNER, E. R. (1983) · Clinical Infectious Diseases · doi:10.1093/clinids/5.4.629 · Cited by 361 · see citing works
Rello, J., Borges-Sa, M., CORREA, H., LEAL, S.-R., & Baraibar, J. (1999) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.160.2.9812034 · Cited by 350 · see citing works
Rotation and Restricted Use of Antibiotics in a Medical Intensive Care Unit
Gruson, D., Hilbert, G., Vargas, F., et al. (2000) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.162.3.9905050 · Cited by 328 · see citing works
Steinberg, J. P., Clark, C. C., & Hackman, B. (1996) · Clinical Infectious Diseases · doi:10.1093/clinids/23.2.255 · Cited by 313 · see citing works
Scheduled Change of Antibiotic Classes
KOLLEF, M. H., Vlasnik, J. J., Sharpless, L., Pasque, C., Murphy, D. M., & Fraser, V. J. (1997) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.156.4.9701046 · Cited by 295 · see citing works
Self-citationLeibovici, L., Paul, M., Poznanski, O., et al. (1997) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.41.5.1127 · Cited by 280 · see citing works
Vidal, F. (1996) · Archives of Internal Medicine · doi:10.1001/archinte.1996.00440170139015 · Cited by 276 · see citing works
Rubin, D. B., Wiener-Kronish, J. P., Murray, J. F., et al. (1990) · Journal of Clinical Investigation · doi:10.1172/jci114733 · Cited by 271 · see citing works
Patient Selection for Clinical Investigation of Ventilator-Associated Pneumonia
Pingleton, S. K., Fagon, J.-Y., & Leeper, K. V. (1992) · CHEST Journal · doi:10.1378/chest.102.5_supplement_1.553s · Cited by 254 · see citing works
Schiappa, D. A., Hayden, M. K., Matushek, M. G., Hashemi, F. N., Sullivan, J., Smith, K. Y., Miyashiro, D. K., Quinn, J. P., Weinstein, R. A., & Trenholme, G. M. (1996) · The Journal of Infectious Diseases · doi:10.1093/infdis/174.3.529 · Cited by 244 · see citing works
Lucas, G. M., Lechtzin, N., Puryear, D. W., et al. (1998) · Clinical Infectious Diseases · doi:10.1086/520311 · Cited by 198 · see citing works
Improving Empiric Antibiotic Selection Using Computer Decision Support
Evans, R. S. (1994) · Archives of Internal Medicine · doi:10.1001/archinte.1994.00420080076008 · Cited by 183 · see citing works
Clinical trials: Design, conduct, and analysis
Rodda, B. E. (1987) · Controlled Clinical Trials · doi:10.1016/0197-2456(87)90162-0 · Cited by 163 · see citing works
Consequences of Bacterial Resistance to Antibiotics in Medical Practice
Acar, J. F. (1997) · Clinical Infectious Diseases · doi:10.1093/clinids/24.supplement_1.s17 · Cited by 123 · see citing works
Bug/drug resistance. Sometimes less is more.
Phelps, C. E. (1989) · PubMed · Cited by 120 · see citing works
The emergent needs for basic research, education, and surveillance of antimicrobial resistance
Jones, R. N. (1996) · Diagnostic Microbiology and Infectious Disease · doi:10.1016/s0732-8893(96)00099-5 · Cited by 105 · see citing works
Phelps, C. E. (1989) · Medical Care · doi:10.1097/00005650-198902000-00009 · Cited by 98 · see citing works
A Novel Antimicrobial Agent Joins the Battle against Resistant Bacteria
Moellering, R. C. (1999) · Annals of Internal Medicine · doi:10.7326/0003-4819-130-2-199901190-00012 · Cited by 87 · see citing works
Sigurdur Einarsson, M. K. (1998) · Scandinavian Journal of Infectious Diseases · doi:10.1080/00365549850160882 · Cited by 86 · see citing works
Enterococcal Bacteremia in the Surgical Intensive Care Unit
Mainous, M. R. (1997) · Archives of Surgery · doi:10.1001/archsurg.1997.01430250078017 · Cited by 68 · see citing works
Predictors of Mortality in Patients with Bacteremia: The Importance of Functional Status
Deulofeu, F., Cervelló, B., Capell, S., et al. (1998) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1998.tb01007.x · Cited by 64 · see citing works
Resistance of artificial biofilms of Pseudomonas aeruginosa to imipenem and tobramycin
Coquet, L., Junter, G., & Jouenne, T. (1998) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/42.6.755 · Cited by 63 · see citing works
Caballero, F. J., Cisneros, J. M., Luque, R., et al. (1998) · Journal of Clinical Microbiology · doi:10.1128/jcm.36.2.520-525.1998 · Cited by 63 · see citing works
Linden, P. K. (1998) · The American Journal of Medicine · doi:10.1016/s0002-9343(98)00152-1 · Cited by 58 · see citing works
Antibiotic Resistance: A View from the Pharmaceutical Industry
Bax, R. P. (1997) · Clinical Infectious Diseases · doi:10.1093/clinids/24.supplement_1.s151 · Cited by 56 · see citing works
Hancock, R. E. W. (1997) · Clinical Infectious Diseases · doi:10.1093/clinids/24.supplement_1.s148 · Cited by 32 · see citing works
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Magiorakos, A.-P., Srinivasan, A., Carey, R. B., Carmeli, Y., Falagas, M. E., Giske, C. G., Harbarth, S., Hindler, J. F., Kahlmeter, G., Olsson-Liljequist, B., et al. (2012) · Clinical Microbiology and Infection · doi:10.1111/j.1469-0691.2011.03570.x · Cited by 14,449 · see citing works
Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock
Dellinger, R. P., Levy, M. M., Rhodes, A., Annane, D., Gerlach, H., Opal, S. M., Sevransky, J. E., Sprung, C. L., Douglas, I. S., Jaeschke, R., et al. (2013) · Critical Care Medicine · doi:10.1097/ccm.0b013e31827e83af · Cited by 9,694 · see citing works
Surviving Sepsis Campaign: International guidelines for management of sepsis and septic shock: 2016.
Rhodes, A., Evans, L. E., Alhazzani, W., Levy, M. M., Antonelli, M., Ferrer, R., Kumar, A., Sevransky, J. E., Sprung, C. L., Nunnally, M. E., et al. (2017) · Intensive Care Medicine · doi:10.1007/s00134-017-4683-6 · Cited by 6,621 · see citing works
Wisplinghoff, H., Bischoff, T., Tallent, S. M., Seifert, H., Wenzel, R. P., & Edmond, M. B. (2004) · Clinical Infectious Diseases · doi:10.1086/421946 · Cited by 4,496 · see citing works
Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem
Pfaller, M. A., & Diekema, D. J. (2007) · Clinical Microbiology Reviews · doi:10.1128/cmr.00029-06 · Cited by 4,174 · see citing works
Surviving Sepsis Campaign: International guidelines for management of sepsis and septic shock: 2016.
Rhodes, A., Evans, L. E., Alhazzani, W., Levy, M. M., Antonelli, M., Ferrer, R., Kumar, A., Sevransky, J. E., Sprung, C. L., Nunnally, M. E., et al. (2017) · Critical Care Medicine · doi:10.1097/ccm.0000000000002255 · Cited by 3,652 · see citing works
Mermel, L. A., Allon, M., Bouza, E., Craven, D. E., Flynn, P., O'Grady, N. P., Raad, I. I., Rijnders, B. J. A., Sherertz, R. J., & Warren, D. K. (2009) · Clinical Infectious Diseases · doi:10.1086/599376 · Cited by 3,638 · see citing works
Freifeld, A. G., Bow, E. J., Sepkowitz, K. A., Boeckh, M. J., Ito, J. I., Mullen, C. A., Raad, I. I., Rolston, K. V., Young, J.-A. H., & Wingard, J. R. (2011) · Clinical Infectious Diseases · doi:10.1093/cid/cir073 · Cited by 3,463 · see citing works
Cecconi, M., Evans, L., Levy, M., & Rhodes, A. (2018) · The Lancet · doi:10.1016/s0140-6736(18)30696-2 · Cited by 2,254 · see citing works
Morrell, M., Fraser, V. J., & Kollef, M. H. (2005) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.49.9.3640-3645.2005 · Cited by 1,286 · see citing works
Self-citationGarey, K. W., Rege, M., Pai, M. P., Mingo, D. E., Suda, K. J., Turpin, R. S., & Bearden, D. T. (2006) · Clinical Infectious Diseases · doi:10.1086/504810 · Cited by 1,171 · see citing works
Epidemiology of Invasive Mycoses in North America
Pfaller, M. A., & Diekema, D. J. (2010) · Critical Reviews in Microbiology · doi:10.3109/10408410903241444 · Cited by 901 · see citing works
Lodise, T. P., McKinnon, P. S., Swiderski, L., & Rybak, M. J. (2003) · Clinical Infectious Diseases · doi:10.1086/375057 · Cited by 604 · see citing works
Banerjee, R., Teng, C. B., Cunningham, S. A., Ihde, S. M., Steckelberg, J. M., Moriarty, J. P., Shah, N. D., Mandrekar, J. N., & Patel, R. (2015) · Clinical Infectious Diseases · doi:10.1093/cid/civ447 · Cited by 570 · see citing works
Ocan, M., Obuku, E. A., Bwanga, F., Akena, D., Richard, S., Ogwal-Okeng, J., & Obua, C. (2015) · BMC Public Health · doi:10.1186/s12889-015-2109-3 · Cited by 504 · see citing works
Septic shock attributed to Candida infection: Importance of empiric therapy and source control.
Kollef, M., Micek, S., Hampton, N., Doherty, J. A., & Kumar, A. (2012) · Clinical Infectious Diseases · doi:10.1093/cid/cis305 · Cited by 477 · see citing works
Self-citationJensen, J. U., Hein, L., Lundgren, B., Bestle, M. H., Mohr, T. T., Andersen, M. H., Thornberg, K. J., Løken, J., Steensen, M., Fox, Z., et al. (2011) · Critical Care Medicine · doi:10.1097/ccm.0b013e31821e8791 · Cited by 356 · see citing works
Tumbarello, M., Posteraro, B., Trecarichi, E. M., Fiori, B., Rossi, M., Porta, R., de Gaetano Donati, K., La Sorda, M., Spanu, T., Fadda, G., et al. (2007) · Journal of Clinical Microbiology · doi:10.1128/jcm.00131-07 · Cited by 343 · see citing works
Leone, M., Bechis, C., Baumstarck, K., Lefrant, J.-Y., Albanèse, J., Jaber, S., Lepape, A., Constantin, J.-M., Papazian, L., Bruder, N., et al. (2014) · Intensive Care Medicine · doi:10.1007/s00134-014-3411-8 · Cited by 243 · see citing works
Hranjec, T., Rosenberger, L. H., Swenson, B., Metzger, R., Flohr, T. R., Politano, A. D., Riccio, L. M., Popovsky, K. A., & Sawyer, R. G. (2012) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(12)70151-2 · Cited by 231 · see citing works
Kett, D. H., Cano, E., Quartin, A. A., Mangino, J. E., Zervos, M. J., Peyrani, P., Cely, C. M., Ford, K. D., Scerpella, E. G., & Ramirez, J. A. (2011) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(10)70314-5 · Cited by 235 · see citing works
Parkins, M. D., Sabuda, D. M., Elsayed, S., & Laupland, K. B. (2007) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkm212 · Cited by 229 · see citing works
Duration of antibiotic therapy for bacteremia: a systematic review and meta-analysis
Havey, T. C., Fowler, R. A., & Daneman, N. (2011) · Critical Care · doi:10.1186/cc10545 · Cited by 187 · see citing works
Khatib, R., Saeed, S., Sharma, M., Riederer, K., Fakih, M. G., & Johnson, L. B. (2006) · European Journal of Clinical Microbiology & Infectious Diseases · doi:10.1007/s10096-006-0096-0 · Cited by 156 · see citing works
McMullan, R., Metwally, L., Coyle, P. V., Hedderwick, S., McCloskey, B., O'Neill, H. J., Patterson, C. C., Thompson, G., Webb, C. H., & Hay, R. J. (2008) · Clinical Infectious Diseases · doi:10.1086/528690 · Cited by 145 · see citing works
Schramm, G. E., Johnson, J. A., Doherty, J. A., Micek, S. T., & Kollef, M. H. (2006) · Critical Care Medicine · doi:10.1097/01.ccm.0000227655.41566.3e · Cited by 145 · see citing works
Self-citationAslam, A., Gajdács, M., Zin, C. S., Ab Rahman, N. S., Ahmed, S. I., Zafar, M. Z., & Jamshed, S. (2020) · Antibiotics · doi:10.3390/antibiotics9090597 · Cited by 142 · see citing works
The effect of time to antifungal therapy on mortality in candidemia associated septic shock
Patel, G. P., Simon, D., Scheetz, M., Crank, C. W., Lodise, T., & Patel, N. (2009) · American Journal of Therapeutics · doi:10.1097/mjt.0b013e3181a1afb7 · Cited by 92 · see citing works
Leroy, G., Lambiotte, F., Thévenin, D., Lemaire, C., Parmentier, E., Devos, P., & Leroy, O. (2011) · Annals of Intensive Care · doi:10.1186/2110-5820-1-50 · Cited by 92 · see citing works
Yokota, P. K. O., Marra, A. R., Martino, M. D. V., Victor, E. S., Durão, M. S., Edmond, M. B., & dos Santos, O. F. P. (2014) · PLoS ONE · doi:10.1371/journal.pone.0104475 · Cited by 85 · see citing works
“If the isolated microorganism was not susceptible by in vitro testing to the antibiotic used, the therapy was considered inadequate [7].”
MethodTop 10 pearls for the recognition, evaluation, and management of maternal sepsis
Shields, A., de Assis, V., & Halscott, T. (2021) · Obstetrics & Gynecology · doi:10.1097/aog.0000000000004471 · Cited by 76 · see citing works
Fungal Sepsis: Optimizing Antifungal Therapy in the Critical Care Setting
Lepak, A., & Andes, D. (2011) · Critical Care Clinics · doi:10.1016/j.ccc.2010.11.001 · Cited by 62 · see citing works
Tumbarello, M., Sanguinetti, M., Trecarichi, E. M., La Sorda, M., Rossi, M., de Carolis, E., de Gaetano Donati, K., Fadda, G., Cauda, R., & Posteraro, B. (2008) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkn381 · Cited by 53 · see citing works
Variability of treatment duration for bacteraemia in the critically ill: A multinational survey.
Corona, A. (2003) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkg447 · Cited by 43 · see citing works
Pilot Study of a Web-Based Antibiotic Decision Management Guide
Bochicchio, G. V., Smit, P. A., Moore, R., Bochicchio, K., Auwaerter, P., Johnson, S. B., Scalea, T., & Bartlett, J. G. (2006) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2005.11.010 · Cited by 41 · see citing works
Clinical Guideline for the Diagnosis and Treatment of Gastrointestinal Infections
The Korean Society of Infectious Diseases, Korean Society for Chemotherapy, & The Korean Society of Clinical Microbiology (2010) · Infection and Chemotherapy · doi:10.3947/ic.2010.42.6.323 · Cited by 18 · see citing works
Dellinger, R. P., Levy, M. M., Carlet, J. M., Bion, J., Parker, M. M., Jaeschke, R., Reinhart, K., Angus, D. C., Brun-Buisson, C., Beale, R., et al. (2008) · Critical Care Medicine · doi:10.1097/01.ccm.0000298158.12101.41 · Cited by 9 · see citing works
Antibiotic de-escalation practices in the intensive care unit: a multicenter observational study
Patanwala, A. E., Abu Sardaneh, A., Alffenaar, J.-W. C., Choo, C. L., Dey, A. L., Duffy, E. J., Green, S. E., Hills, T. E., Howle, L. M., Joseph, J. A., et al. (2025) · Annals of Pharmacotherapy · doi:10.1177/10600280241271223 · Cited by 2 · see citing works
- Authors
- Ibrahim, E. H., Sherman, G., Ward, S., Fraser, V. J., & Kollef, M. H.
- Affiliations
- Barnes-Jewish Hospital (US)
- Corresponding author
- Kollef, Marin H.
- Venue
- Chest
- Publisher
- Elsevier BV
- Published
- 2000-07
- Volume
- 118
- Issue
- 1
- Pages
- 146-155
- ISSN
- 0012-3692 (ISSN-L)
- OpenAlex
- W2131443556
- Cited by
- 1,779
- References
- 49
- Citations by year
- 2026: 9 · 2025: 12 · 2024: 37 · 2023: 28 · 2022: 43 · 2021: 55 · 2020: 68 · 2019: 46 · 2018: 45 · 2017: 50 · 2016: 63 · 2015: 62 · 2014: 84 · 2013: 79 · 2012: 113
- FWCI
- 42.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- CHEST Journal (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Public Health Service (UR8/CCU715087)
- Topics
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
- Keywords
- bloodstream infection, in-hospital mortality, intensive care unit patients, candidiasis, vancomycin-resistant enterococci, oxacillin-resistant Staphylococcus aureus, coagulase-negative staphylococci, Pseudomonas aeruginosa, prior antibiotic use, antimicrobial susceptibility, nosocomial infections, sepsis
- MeSH terms
- Aged, Anti-Bacterial Agents, Catheterization, Central Venous, Drug Resistance, Microbial, Female, Humans, Intensive Care Units, Male, Middle Aged, Prospective Studies, Respiration, Artificial, Urinary Catheterization, Logistic Models, Survival Analysis, Bacteremia, Critical Illness, Hospital Mortality
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