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03-01-2024 | Original Article

Mortality risk factors and fulminant sub-phenotype in anaerobic bacteremia: a 10-year retrospective, multicenter, observational cohort study

Authors: Kentaro Nagaoka, N. Iwanaga, Y. Takegoshi, Y. Murai, H. Kawasuji, M. Miura, Y. Sato, Y. Hatakeyama, H. Ito, Y. Kato, N. Shibayama, Y. Terasaki, T. Fujimura, T. Takazono, K. Kosai, A. Sugano, Y. Morinaga, K. Yanagihara, H. Mukae, Y. Yamamoto

Published in: European Journal of Clinical Microbiology & Infectious Diseases | Issue 3/2024

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Abstract

Purpose

During the last decade, the incidence of anaerobic bacteremia (AB) has been increasing. Patients with AB may develop complex underlying diseases, which can occasionally be accompanied by fatal or fulminant outcomes. However, the risk factors for AB-related mortality remain unclear. Herein, we sought to elucidate the risk factors for AB-related mortality.

Methods

In this multicenter, retrospective, observational study, we enrolled patients with culture-proven AB from six tertiary hospitals in Japan, between January 2012 and December 2021. Data on patient and infection characteristics, laboratory findings, treatment, and outcome were collected, and their associations with mortality were analyzed.

Results

A total of 520 participants were included. The 30-day mortality in the study cohort was 14.0% (73 patients), and malignant tumors were frequently observed comorbidities in 48% of the entire cohort. Multivariable logistic regression analysis showed a Charlson comorbidity score of > 6, serum creatinine level of > 1.17 mg/dL, and hypotension to be independent risk factors for 30-day mortality in AB (odds ratios [ORs] 2.12, 2.25, and 5.12, respectively; p < 0.05), whereas drainage significantly reduced this risk (OR, 0.28; p < 0.0001). Twelve patients (2.3% of the whole cohort and 16.4% of the deceased patients) presented with extremely rapid progression leading to fatal outcome, consistent with “fulminant AB.”

Conclusions

This study identified acute circulatory dysfunction and performance of drainage as independent predictive factors for 30-day AB-related mortality and revealed the existence of a fulminant AB sub-phenotype. Our findings could serve as a practical guide to predict the clinical outcomes of AB.
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Metadata
Title
Mortality risk factors and fulminant sub-phenotype in anaerobic bacteremia: a 10-year retrospective, multicenter, observational cohort study
Authors
Kentaro Nagaoka
N. Iwanaga
Y. Takegoshi
Y. Murai
H. Kawasuji
M. Miura
Y. Sato
Y. Hatakeyama
H. Ito
Y. Kato
N. Shibayama
Y. Terasaki
T. Fujimura
T. Takazono
K. Kosai
A. Sugano
Y. Morinaga
K. Yanagihara
H. Mukae
Y. Yamamoto
Publication date
03-01-2024
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Clinical Microbiology & Infectious Diseases / Issue 3/2024
Print ISSN: 0934-9723
Electronic ISSN: 1435-4373
DOI
https://doi.org/10.1007/s10096-023-04743-1

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