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Some Routine Laboratory Measurements And Antibiotic Choice As Potential Predictors of Mortality in The Pediatric İntensive Care Unit: A Cross-Sectional Study

Year 2019, Volume: 7 Issue: Ek - IRUPEC 2019 Kongresi Tam Metin Bildirileri, 305 - 313, 10.12.2019

Abstract

White blood cell (WBC), platelet (PLT) count, and CRP are some basic parameters to follow the outcome of patients in intensive care units. This study aimed to evaluate the differences in the outcome of patients related to some routine laboratory measurements and antibiotic preferences.
Methods: The participants of the study consisted of 179 pediatric ICU inpatients with gram-positive culture results. Hospital records covering the years 2016 to 2019 were reviewed. Other than the mortality status, data were collected on age, sex, the presence of fever, culture results, antibiotic preferences, and laboratory parameters such as WBC, PLT, and CRP levels.
Results: The median (IQR) age of the patients was 33.00 (8.00-66.00) months; 109 (60.89%) were boys, while 70 (39.11%) were girls. Of the patients, 90 (50.3%) had positive culture results, 59 (33%) received vancomycin, 31 ‎(17.3%) received teicoplanin, and 34 (18.9%) had a fatal outcome.‎ The cultured organisms were as follows: Staph. spp. (n=56, 31.3%), methicillin-resistant Staph. epidermidis (n=81, 45.3%), Staph. aureus (n=22, 12.3%), Staph. epidermidis (n=15, 8.4%), and methicillin-resistant Staph. aureus (n=5, 2.8%). WBC and PLT levels were higher in survived patients than the deceased ones (p=0.001 and p<0.001‎‎, respectively. There was no significant association of mortality and any of the studied categorical variables (p>0.05).‎
Conclusion: CRP and PLT are useful indicators for the diagnosis of serious bacterial infections and the prediction of the clinical outcome. There is no difference between using vancomycin or teicoplanin concerning mortality in the ICU.

References

  • References 1. Waheed U, Williams P, Brett S et al. White cell count and intensive care unit outcome. Anaesthesia. 2003 Feb;58(2):180–2. 2. Zarychanski R, Houston DS. Assessing thrombocytopenia in the intensive care unit: the past, present, and future. Hematol Am Soc Hematol Educ Progr. 2017 Dec;2017(1):660–6. 3. Gao L, Liu X, Zhang D et al. Early diagnosis of bacterial infection in patients with septicopyemia by laboratory analysis of PCT, CRP and IL-6. Exp Ther Med. 2017 Jun;13(6):3479–83. 4. Li Z, Wang H, Liu J et al. Serum soluble triggering receptor expressed on myeloid cells-1 and procalcitonin can reflect sepsis severity and predict prognosis: a prospective cohort study. Mediators Inflamm. 2014;2014:641039. 5. Sampedro GR, Bubeck Wardenburg J. Staphylococcus aureus in the Intensive Care Unit: Are These Golden Grapes Ripe for a New Approach? J Infect Dis. 2017 Feb;215(suppl_1):S64–70. 6. Cavalcanti AB, Goncalves AR, Almeida CS et al. Teicoplanin versus vancomycin for proven or suspected infection. Cochrane database Syst Rev. 2010 Jun;(6):CD007022. 7. von Elm E, Altman DG, Egger M et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg. 2014 Dec;12(12):1495–9. 8. Cleri DJ, Corrado ML, Seligman SJ. Quantitative culture of intravenous catheters and other intravascular inserts. J Infect Dis. 1980;141(6):781–6. 9. Kloos WE, Bannerman TL. Manual of clinical microbiology. Am Soc Microbiol Washington, DC. 1991; 10. Faul F, Erdfelder E, Lang A-G et al. Power 3:A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007; 11. Zarkesh M, Sedaghat F, Heidarzadeh A et al. Diagnostic value of IL-6, CRP, WBC, and absolute neutrophil count to predict serious bacterial infection in febrile infants. Acta Med Iran. 2015 Jul;53(7):408–11. 12. Hsiao AL, Baker MD. Fever in the new millennium: a review of recent studies of markers of serious bacterial infection in febrile children. Curr Opin Pediatr. 2005 Feb;17(1):56–61. 13. Abdollahi A, Shoar S, Nayyeri F et al. Diagnostic Value of Simultaneous Measurement of Procalcitonin, Interleukin-6 and hs-CRP in Prediction of Early-Onset Neonatal Sepsis. Mediterr J Hematol Infect Dis. 2012;4(1):e2012028. 14. Bachur RG, Harper MB. Predictive model for serious bacterial infections among infants younger than 3 months of age. Pediatrics. 2001 Aug;108(2):311–6. 15. de Stoppelaar SF, van ’t Veer C, van der Poll T. The role of platelets in sepsis. Thromb Haemost. 2014 Oct;112(4):666–77. 16. Ghosh TK, Khan N, Malik A. Platelet auto-antibodies in septicaemic patients. Indian J Pathol Microbiol. 1999 Jan;42(1):31–5. 17. Greinacher A, Selleng K. Thrombocytopenia in the intensive care unit patient. Hematol Am Soc Hematol Educ Progr. 2010;2010:135–43. 18. Campion M, Scully G. Antibiotic Use in the Intensive Care Unit: Optimization and De-Escalation. J Intensive Care Med. 2018 Dec;33(12):647–55. 19. Bubacz MR. Community-acquired methicillin-resistant Staphylococcus aureus: an ever-emerging epidemic. AAOHN J. 2007 May;55(5):193–4. 20. Maclayton DO, Hall RG 2nd. Pharmacologic treatment options for nosocomial pneumonia involving methicillin-resistant Staphylococcus aureus. Ann Pharmacother. 2007 Feb;41(2):235–44. 21. Wood MJ. Comparative safety of teicoplanin and vancomycin. J Chemother. 2000 Nov;12 Suppl 5:21–5. 22. Wood MJ. The comparative efficacy and safety of teicoplanin and vancomycin. J Antimicrob Chemother. 1996 Feb;37(2):209–22.
Year 2019, Volume: 7 Issue: Ek - IRUPEC 2019 Kongresi Tam Metin Bildirileri, 305 - 313, 10.12.2019

Abstract

References

  • References 1. Waheed U, Williams P, Brett S et al. White cell count and intensive care unit outcome. Anaesthesia. 2003 Feb;58(2):180–2. 2. Zarychanski R, Houston DS. Assessing thrombocytopenia in the intensive care unit: the past, present, and future. Hematol Am Soc Hematol Educ Progr. 2017 Dec;2017(1):660–6. 3. Gao L, Liu X, Zhang D et al. Early diagnosis of bacterial infection in patients with septicopyemia by laboratory analysis of PCT, CRP and IL-6. Exp Ther Med. 2017 Jun;13(6):3479–83. 4. Li Z, Wang H, Liu J et al. Serum soluble triggering receptor expressed on myeloid cells-1 and procalcitonin can reflect sepsis severity and predict prognosis: a prospective cohort study. Mediators Inflamm. 2014;2014:641039. 5. Sampedro GR, Bubeck Wardenburg J. Staphylococcus aureus in the Intensive Care Unit: Are These Golden Grapes Ripe for a New Approach? J Infect Dis. 2017 Feb;215(suppl_1):S64–70. 6. Cavalcanti AB, Goncalves AR, Almeida CS et al. Teicoplanin versus vancomycin for proven or suspected infection. Cochrane database Syst Rev. 2010 Jun;(6):CD007022. 7. von Elm E, Altman DG, Egger M et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg. 2014 Dec;12(12):1495–9. 8. Cleri DJ, Corrado ML, Seligman SJ. Quantitative culture of intravenous catheters and other intravascular inserts. J Infect Dis. 1980;141(6):781–6. 9. Kloos WE, Bannerman TL. Manual of clinical microbiology. Am Soc Microbiol Washington, DC. 1991; 10. Faul F, Erdfelder E, Lang A-G et al. Power 3:A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007; 11. Zarkesh M, Sedaghat F, Heidarzadeh A et al. Diagnostic value of IL-6, CRP, WBC, and absolute neutrophil count to predict serious bacterial infection in febrile infants. Acta Med Iran. 2015 Jul;53(7):408–11. 12. Hsiao AL, Baker MD. Fever in the new millennium: a review of recent studies of markers of serious bacterial infection in febrile children. Curr Opin Pediatr. 2005 Feb;17(1):56–61. 13. Abdollahi A, Shoar S, Nayyeri F et al. Diagnostic Value of Simultaneous Measurement of Procalcitonin, Interleukin-6 and hs-CRP in Prediction of Early-Onset Neonatal Sepsis. Mediterr J Hematol Infect Dis. 2012;4(1):e2012028. 14. Bachur RG, Harper MB. Predictive model for serious bacterial infections among infants younger than 3 months of age. Pediatrics. 2001 Aug;108(2):311–6. 15. de Stoppelaar SF, van ’t Veer C, van der Poll T. The role of platelets in sepsis. Thromb Haemost. 2014 Oct;112(4):666–77. 16. Ghosh TK, Khan N, Malik A. Platelet auto-antibodies in septicaemic patients. Indian J Pathol Microbiol. 1999 Jan;42(1):31–5. 17. Greinacher A, Selleng K. Thrombocytopenia in the intensive care unit patient. Hematol Am Soc Hematol Educ Progr. 2010;2010:135–43. 18. Campion M, Scully G. Antibiotic Use in the Intensive Care Unit: Optimization and De-Escalation. J Intensive Care Med. 2018 Dec;33(12):647–55. 19. Bubacz MR. Community-acquired methicillin-resistant Staphylococcus aureus: an ever-emerging epidemic. AAOHN J. 2007 May;55(5):193–4. 20. Maclayton DO, Hall RG 2nd. Pharmacologic treatment options for nosocomial pneumonia involving methicillin-resistant Staphylococcus aureus. Ann Pharmacother. 2007 Feb;41(2):235–44. 21. Wood MJ. Comparative safety of teicoplanin and vancomycin. J Chemother. 2000 Nov;12 Suppl 5:21–5. 22. Wood MJ. The comparative efficacy and safety of teicoplanin and vancomycin. J Antimicrob Chemother. 1996 Feb;37(2):209–22.
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Details

Primary Language English
Subjects Health Care Administration
Journal Section Congress Proceedings
Authors

Feyza İnceköy Girgin This is me

Publication Date December 10, 2019
Acceptance Date January 16, 2020
Published in Issue Year 2019 Volume: 7 Issue: Ek - IRUPEC 2019 Kongresi Tam Metin Bildirileri

Cite

Vancouver İnceköy Girgin F. Some Routine Laboratory Measurements And Antibiotic Choice As Potential Predictors of Mortality in The Pediatric İntensive Care Unit: A Cross-Sectional Study. pediatr pract res. 2019;7(Ek):305-13.