The Susceptibility of MDR-K. Pneumoniae to Polymyxin B Plus its Nebulised Form Versus Polymyxin B Alone in Critically Ill South Asian Patients
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29 janv. 2021
À propos de cet article
Catégorie d'article: Research Article
Publié en ligne: 29 janv. 2021
Pages: 28 - 36
Reçu: 15 juil. 2020
Accepté: 23 nov. 2020
DOI: https://doi.org/10.2478/jccm-2020-0044
Mots clés
© 2021 Md. Jahidul Hasan, Raihan Rabbani, Ahmad Mursel Anam, Ario Santini, Shihan Mahmud Redwanul Huq, published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Fig. 1
Fig. 2
Clinical outcomes of patients with intravenous polymyxin B with or without the nebulised form_
| Parameter | Odds ratio (95% confidence interval) | p-value |
|---|---|---|
| Microbial eradication | 0.19 (0.06-0.58) | 0.003 |
| Secondary bacterial infection | 0.17 (0.05-0.59) | 0.005 |
| 30-day mortality | 0.45 (0.14-1.43) | 0.178 |
Demographic and baseline characteristics of the patients
| Variables | |||
|---|---|---|---|
| Characterisitcs | p-value | ||
| PIVNL group (n=64) | PIV group (n=57) | ||
| Age (year) | |||
| Mean | 64.1±16.1 | 63.9±14.3 | |
| Range (min-max) | 20-86 | 20-87 | 0.950 |
| Gender | |||
| Male | 37 | 33 | |
| Female | 27 | 24 | 0.993 |
| Comorbidities | |||
| Hypertension, n (%) | 31 (48.4) | 26 (45.6) | 0.756 |
| Diabetes mellitus, n (%) | 30 (46.8) | 27 (47.3) | 0.957 |
| Chronic lung diseases, n (%) | 16 (25) | 13 (22.8) | 0.778 |
| APACHE II Score (0-30) | |||
| Mean | 18±4.8 | 18.3±5.5 | |
| Range (min-max) | 10–30 | 8–30 | 0.727 |
| C-reactive protein (<10.0 mg/mL) | |||
| Mean | 161.7(112.8) | 139.2±105.3 | |
| Range (min-max) | 11.7–393.6 | 10.3–390.3 | 0.260 |
| Procalcitonin (<0.1 ng/mL) | |||
| Mean | 7.5(17.3) | 7.4±14.4 | |
| Range (min-max) | 0.2–114 | 0.1–68.5 | 0.976 |
| White blood cell (4-11 K/μL) | |||
| Mean | 19.2(7.3) | 18.9±7.3 | |
| Range (min-max) | 9.7–46.1 | 11.1–47.6 | 0.823 |
| Serum creatinine (0.8-1.4 mg/dL) | |||
| Mean | 1.6(0.5) | 1.5±0.5 | |
| Range (min-max) | 0.6–2.3 | 0.6–2.5 | 0.905 |
Extubation, reintubation and hospitalisation time of the patients
| Group | Time to extubation, n (%) | p-value | ICU length-of-stay, n (%) | p-value | 21-day reintubation, n (%) | P value |
|---|---|---|---|---|---|---|
| ≥4 weeks: nil | ≥4 weeks: 4 (6.25) | |||||
| PIVNL | ≥3 weeks: 1 (1.5) | ≥3 weeks: 7 (10.9) | ||||
| (n=64) | ≥2 weeks: 19 (29.7) | ≥2 weeks: 38 (59.4) | 8 (12.5) | |||
| ≥1 week: 40 (62.5) | ≥1 week: 14 (21.9) | |||||
| <1 week: 4 (6.3) | <1 week: 1 (1.6) | |||||
| ≥4 weeks: 13 (22.8) | 0.001** | ≥1 weeks: 36 (63.2) | 0.002** | 0.089** | ||
| ≥3 weeks: 15 (26.3) | ≥3 weeks: 14 (24.5) | |||||
| PIV | ≥2 weeks: 25 (43.9) | ≥2 weeks: 4 (7.0) | 17 (29.8) | |||
| (n=57) | ≥1 week: 4 (7.0) | ≥1 week: nil | ||||
| <1 week: nil | <1 week: 3 (5.3) |