Περίληψη:
Background: Choice of empirically prescribed antimicrobials for sepsis
management depends on epidemiological factors. The epidemiology of
sepsis in Greece was studied in two large-periods.
Methods: Sepsis due to bloodstream infections (BSI) from July 2006 until
March 2013 was recorded in a multicenter study in 46 departments.
Patients were divided into sepsis admitted in the emergencies and
hospitalized in the general ward (GW) and sepsis developing after
admission in the Intensive Care Unit (ICU). The primary endpoints were
the changes of epidemiology and the factors related with BSIs by
multidrug-resistant (MDR) pathogens; the secondary endpoint was the
impact of de-escalation on antimicrobial therapy.
Results: 754 patients were studied; 378 from 2006-2009 and 376 from
2010-2013. Major differences were recorded between periods in the GW.
They involved increase of: sepsis severity; the incidence of underlying
diseases; the incidence of polymicrobial infections; the emergence of
Klebsiella pneumoniae as a pathogen; and mortality. Factors
independently related with BSI by MDR pathogens were chronic
hemofiltration, intake of antibiotics the last three months and
residence into long-term care facilities. De-escalation in BSIs by fully
susceptible Gram-negatives did not affect final outcome. Similar
epidemiological differences were not found in the ICU; MDR
Gram-negatives predominated in both periods.
Conclusions: The epidemiology of sepsis in Greece differs in the GW and
in the ICU. De-escalation in the GW is a safe strategy.
Συγγραφείς:
Koupetori, Marina
Retsas, Theodoros
Antonakos, Nikolaos and
Vlachogiannis, Glykeria
Perdios, Ioannis
Nathanail, Christos and
Makaritsis, Konstantinos
Papadopoulos, Antonios
Sinapidis,
Dimitrios
Giamarellos-Bourboulis, Evangelos J.
Pneumatikos,
Ioannis
Gogos, Charalambos
Armaganidis, Apostolos and
Paramythiotou, Elisabeth
Hellenic Sepsis Study Grp
