Risk factors for mortality in patients with Serratia marcescens bacteremia

Yonsei Med J. 2015 Mar;56(2):348-54. doi: 10.3349/ymj.2015.56.2.348.

Abstract

Purpose: Over the last 30 years, Serratia marcescens (S. marcescens) has emerged as an important pathogen, and a common cause of nosocomial infections. The aim of this study was to identify risk factors associated with mortality in patients with S. marcescens bacteremia.

Materials and methods: We performed a retrospective cohort study of 98 patients who had one or more blood cultures positive for S. marcescens between January 2006 and December 2012 in a tertiary care hospital in Seoul, South Korea. Multiple risk factors were compared with association with 28-day all-cause mortality.

Results: The 28-day mortality was 22.4% (22/98 episodes). In a univariate analysis, the onset of bacteremia during the intensive care unit stay (p=0.020), serum albumin level (p=0.011), serum C-reactive protein level (p=0.041), presence of indwelling urinary catheter (p=0.023), and Sequential Oran Failure Assessment (SOFA) score at the onset of bacteremia (p<0.001) were significantly different between patients in the fatal and non-fatal groups. In a multivariate analysis, lower serum albumin level and an elevated SOFA score were independently associated with 28-day mortality [adjusted odds ratio (OR) 0.206, 95% confidential interval (CI) 0.044-0.960, p=0.040, and adjusted OR 1.474, 95% CI 1.200-1.810, p<0.001, respectively].

Conclusion: Lower serum albumin level and an elevated SOFA score were significantly associated with adverse outcomes in patients with S. marcescens bacteremia.

Keywords: Serratia marcescens; bacteremia; mortality; risk factors.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia / drug therapy
  • Bacteremia / microbiology
  • Bacteremia / mortality*
  • Cross Infection / mortality
  • Female
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Multiple Organ Failure
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Risk Factors
  • Serratia Infections / diagnosis
  • Serratia Infections / drug therapy
  • Serratia Infections / mortality*
  • Serratia marcescens / drug effects
  • Serratia marcescens / isolation & purification*
  • Severity of Illness Index
  • Survival Rate
  • Time Factors
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents