The Thai Journal of Pharmaceutical Sciences


The present study examined the treatment outcomes and factors related to mortality in patients with Enterobacter spp., Serratia spp., Citrobacter spp., Providencia spp., I-indole-positive Proteus spp., and Morganella spp. (ESCPIM) bloodstream infections and determined the susceptibility of ESCPIM pathogens to antimicrobial compounds. This retrospective study was performed at a university hospital in Thailand, using records from March 2017 to December 2018. Fifty-six patients with ESCPIM bacteremia were included. Approximately, half the patient cohort (55.4%) was infected with Enterobacter spp. The in-hospital mortality rate was 23.2%. Of the 56 patients studied, 20 patients (35.7%) had received a carbapenem treatment regimen, whereas 36 patients (64.3%) were treated with non-carbapenem regimens. The mortality rates in the carbapenem and non-carbapenem treatment regimens were 30% and 19.4%, respectively, although this difference was not statistically significant. In multivariate analysis of factors related to treatment outcome, only mechanical ventilator use and intensive care unit (ICU) admission significantly predicted 30-day mortality. Piperacillin/tazobactam, carbapenems, and aminoglycosides were the antimicrobial agents with most activity against the ESCPIM isolates assayed in the present study. In conclusion, patients with ESCPIM septicemia showed an in-hospital mortality rate of approximately one in four. Mechanical ventilator use and ICU admission were significant predictors of mortality. Thus, these critical conditions have to be concerned to improve patient outcomes.


Faculty of Pharmaceutical Sciences, Chulalongkorn University

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