Evidence map›Paper›PMID 35738385›Full record

ArticleJournal of global antimicrobial resistance2022

Attributable mortality and excess length of stay associated with third-generation cephalosporin-resistant Enterobacterales bloodstream infections: a prospective cohort study in Suva, Fiji.

Michael J Loftus, Tracey E M W Young-Sharma, Sue J Lee, Shitanjni Wati, Gnei Z Badoordeen, Luke V Blakeway, Sally M H Byers, Allen C Cheng, Ben S Cooper, Hugh Cottingham and 13 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of global antimicrobial resistance, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Article
  6. Article
  7. Molecular and clinical epidemiology of carbapenem resistantThe Lancet regional health. Western Pacific · 2024
    Article
  8. Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors at 6 institutions in 5 countries.

Michael J LoftusDepartment of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia.
Tracey E M W Young-SharmaColonial War Memorial Hospital, Suva, Fiji.
Sue J LeeDepartment of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia.
Shitanjni WatiColonial War Memorial Hospital, Suva, Fiji.
Gnei Z BadoordeenDepartment of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia.
Luke V BlakewayDepartment of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia.
Sally M H ByersDepartment of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia.
Allen C ChengDepartment of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Ben S CooperCentre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom; Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand.
Hugh CottinghamDepartment of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia.
Adam W J JenneyDepartment of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia; Fiji National University, Suva, Fiji.
Jane HawkeyDepartment of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia.
Nenad MacesicDepartment of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia; Centre to Impact AMR, Monash University, Melbourne, Australia.
Ravi NaiduColonial War Memorial Hospital, Suva, Fiji.
Amitesh PrasadColonial War Memorial Hospital, Suva, Fiji.
Vinita PrasadColonial War Memorial Hospital, Suva, Fiji.
Litia TudravuColonial War Memorial Hospital, Suva, Fiji.
Timoci VakatawaColonial War Memorial Hospital, Suva, Fiji.
Elke van GorpDepartment of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia.
Jessica A WisniewskiDepartment of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia.
Eric RafaiFiji Ministry of Health and Medical Services, Suva, Fiji.
Anton Y PelegDepartment of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia; Infection and Immunity Program, Monash Biomedicine Discovery Institute, Department of Microbiology, Monash University, Clayton, Australia. Electronic address: anton.peleg@monash.edu.
Andrew J StewardsonDepartment of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia. Electronic address: andrew.stewardson@monash.edu.
The Alfred Hospital · AUColonial War Memorial Hospital · FJDiscovery Institute · USMahidol University · THMinistry Of Health · FJMonash Alfred Psychiatry Research centre · AU

Funding

Wellcome TrustWellcome Trust 209142/Z/17/Z
6 · The paper itself

Abstract

objectivesThere are scant primary clinical data on antimicrobial resistance (AMR) burden from low- and middle-income countries (LMICs). We adapted recent World Health Organization methodology to measure the effect of third-generation cephalosporin resistance (3GC-R) on mortality and excess length of hospital stay in Fiji.

methodsWe conducted a prospective cohort study of inpatients with Enterobacterales bloodstream infections (BSIs) at Colonial War Memorial Hospital, Suva. We used cause-specific Cox proportional hazards models to estimate the effect of 3GC-R on the daily risk (hazard) of in-hospital mortality and being discharged alive (competing risks), and we used multistate modelling to estimate the excess length of hospital stay.

resultsFrom July 2020 to February 2021 we identified 162 consecutive Enterobacterales BSIs; 3GC-R was present in 66 (40.7%). Crude mortality for patients with 3GC-susceptible and 3GC-R BSIs was 16.7% (16/96) and 30.3% (20/66), respectively. 3GC-R was not associated with the in-hospital mortality hazard rate (adjusted hazard ratio [aHR] 1.13, 95% confidence interval [CI] 0.51-2.53) or being discharged alive (aHR 0.99, 95% CI 0.65-1.50), whereas Charlson comorbidity index score (aHR 1.62, 95% CI 1.36-1.93) and Pitt bacteraemia score (aHR 3.57, 95% CI 1.31-9.71) were both associated with an increased hazard rate of in-hospital mortality. 3GC-R was associated with an increased length of stay of 2.6 days (95% CI 2.5-2.8). 3GC-R was more common among hospital-associated infections, but genomics did not identify clonal transmission.

conclusionPatients with Enterobacterales BSIs in Fiji had high mortality. There were high rates of 3GC-R, which was associated with increased hospital length of stay but not with in-hospital mortality.

Indexed as

BacteremiaCross InfectionCephalosporinsFijiHumansLength of StayProspective StudiesCephalosporinsAntimicrobial resistanceBloodstream infectionEnterobacteralesFijiMortality

Identifiers

PMID35738385
PMCPMC9452645
OpenAlexW4283163329

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.