Blood cultures and appropriate antimicrobial administration after achieving sustained return of spontaneous circulation in adults with nontraumatic out-of-hospital cardiac arrest

Chih Hao Lin, Po Lin Chen, Yi Tzu Huang, Ching Yu Ho, Chih Chia Hsieh, William Yu Chung Wang, Ching Chi Lee, Wen Chien Ko

研究成果: Article同行評審

摘要

We aimed to determine the incidence of bacteremia and prognostic effects of prompt administration of appropriate antimicrobial therapy (AAT) on nontraumatic out-of-hospital cardiac arrest (OHCA) patients achieving a sustained return of spontaneous circulation (sROSC), compared with non-OHCA patients. In the multicenter case-control study, nontraumatic OHCA adults with bacteremia episodes after achieving sROSC were defined as case patients, and non-OHCA patients with community-onset bacteremia in the emergency department were regarded as control patients. Initially, case patients had a higher bacteremia incidence than non-OHCA visits (231/2171, 10.6% vs. 10,430/314,620, 3.3%; p < 0.001). Compared with the matched control (2288) patients, case (231) patients experienced more bacteremic episodes due to low respiratory tract infections, fewer urosepsis events, fewer Escherichia coli bacteremia, and more streptococcal and anaerobes bacteremia. Antimicrobial-resistant organisms, such as methicillin-resistant Staphylococcus aureus and extended-spectrum beta-lactamase-producing Enterobacteriaceae, were frequently evident in case patients. Notably, each hour delay in AAT administration was associated with an average increase of 10.6% in crude 30-day mortality rates in case patients, 0.7% in critically ill control patients, and 0.3% in less critically ill control patients. Conclusively, the incidence and characteristics of bacteremia differed between the nontraumatic OHCA and non-OHCA patients. The incorporation of blood culture samplings and rapid AAT administration as first-aids is essential for nontraumatic OHCA patients after achieving sROSC.

原文English
期刊Antibiotics
10
發行號7
DOIs
出版狀態Published - 2021 七月

All Science Journal Classification (ASJC) codes

  • 微生物學
  • 生物化學
  • 藥理學、毒理學和藥劑學 (全部)
  • 微生物學(醫學)
  • 傳染性疾病
  • 藥學(醫學)

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