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The Association between Medical History-based Risks and Sepsis Events in Immunocompromised Patients according to Type III Stratification of the Indonesian Regulation on the Prospective Antimicrobial System (Regulasi Antimikroba Sistem Prospektif / RASPRO)

Abstract

Background: The Indonesian Regulation on the Prospective Antimicrobial System (Regulasi Antimikroba Sistem Prospektif / RASPRO) is a novel program. Its role has been reinforced by the Indonesian Ministry of Law and Human Rights Stipulation, which may predict the risk of sepsis events. Our study aimed to evaluate whether the risk factors listed in the RASPRO consensus have actual effects on sepsis events.

Method: The study was a retrospective cohort using secondary data with 98 subjects. The subjects were categorized into two groups, i.e., the RASPRO group with type III stratification (RASPRO Group) and Non-type III stratification RASPRO group (Non-RASPRO Group). Subjects with infection but with conditions other than the abovementioned criteria were categorized into the Non-RASPRO group.

Results: We found that among subjects in the RASPRO group, a history of antibiotic use over the past <30 days (OR 3.42; 95%CI 1.32–8.85; p=0.011) and a history of having procedure using medical instruments within the last <30 days (OR 2.62; 95%CI 1.06–6.45; p=0.037) seemed to be greatest risk factors for sepsis events.

Conclusion: The RASPRO group has a higher risk for sepsis events than the non-RASPRO with a history of antibiotic undergoing a procedure using a medical instrument within the last <30 days possessed the greatest risk factors for sepsis events.

References

  1. Vincent JL, Jones G, David S, Olariu E, Cadwell KK. Frequency and mortality of septic shock in Europe and North America: A systematic review and meta-analysis. Crit Care [Internet]. 2019;23(1):1–11. Available from: https://doi.org/10.1186/s13054-019-2478-6
  2. Marik PE, Taeb AM. SIRS, qSOFA and new sepsis definition. J Thorac Dis [Internet]. 2017;9(4):943–5. Available from: http://dx.doi.org/10.21037/jtd.2017.03.125
  3. Singer M, Deutschman CS, Seymour C, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA - J Am Med Assoc [Internet]. 2016;315(8):801–10. Available from: http://dx.doi.org/10.1001/jama.2016.0287
  4. Gyawali B, Ramakrishna K, Dhamoon AS. Sepsis: The evolution in definition, pathophysiology, and management. SAGE Open Med [Internet]. 2019;7:1–13. Available from: https://doi.org/10.1177/2050312119835043
  5. Kalil AC, Opal SM. Sepsis in the Severely Immunocompromised Patient. Curr Infect Dis Rep [Internet]. 2015;17(32):1–10. Available from: https://doi.org/10.1007/s11908-015-0487-4
  6. Kang CI, Song JH, Chung DR, Peck KR, Ko KS, Yeom JS, et al. Risk factors and pathogenic significance of severe sepsis and septic shock in 2286 patients with gram-negative bacteremia. J Infect [Internet]. 2011;62(1):26–33. Available from: http://dx.doi.org/10.1016/j.jinf.2010.10.010
  7. Aliberti S, Di Pasquale M, Zanaboni AM, Cosentini R, Brambilla AM, Seghezzi S, et al. Stratifying risk factors for multidrug-resistant pathogens in hospitalized patients coming from the community with pneumonia. Clin Infect Dis [Internet]. 2012;54(4):470–8. Available from: https://doi.org/10.1093/cid/cir840
  8. Gomila A, Shaw E, Carratalà J, Leibovici L, Tebé C, Wiegand I, et al. Predictive factors for multidrug-resistant gram-negative bacteria among hospitalised patients with complicated urinary tract infections. Antimicrob Resist Infect Control [Internet]. 2018;7(1):1–11. Available from: https://doi.org/10.1186/s13756-018-0401-6
  9. Natadidjaja RI. Konsep RASPRO: Metode Tata Guna Antibiotik Bijak dalam Rangka Menjalankan Fungsi PPRA di Rumah Sakit [Internet]. 1st ed. Jakarta: Penerbit ERLANGGA; 2020. Available from: erlangga.co.id
  10. Wang HE, Shapiro NI, Griffin R, Safford MM, Judd S, Howard G. Chronic Medical Conditions and Risk of Sepsis. PLoS One [Internet]. 2012;7(10):1–7. Available from: https://doi.org/10.1371/journal.pone.0048307
  11. Wang Z, Ren J, Wang G, Liu Q, Guo K, Li J. Association between diabetes mellitus and outcomes of patients with sepsis: A meta-analysis. Med Sci Monit [Internet]. 2017;23:3546–55. Available from: http://www.medscimonit.com/abstract/index/idArt/903144
  12. Frydrych LM, Fattahi F, He K, Ward PA, Delano MJ. Diabetes and sepsis: Risk, recurrence, and ruination. Front Endocrinol (Lausanne) [Internet]. 2017;8(OCT):1–22. Available from: https://doi.org/10.3389/fendo.2017.00271
  13. Cillóniz C, Dominedò C, Ielpo A, Ferrer M, Gabarrus A, Battaglini D, et al. Risk and Prognostic Factors in Very Old Patients with Sepsis Secondary to Community-Acquired Pneumonia. J Clin Med [Internet]. 2019;8(7):1–12. Available from: https://doi.org/10.3390/jcm8070961
  14. Patolia S, Abate G, Patel N, Patolia S, Frey S. Risk factors and outcomes for multidrug- resistant Gram-negative bacilli bacteremia. Ther Adv Infect Dis [Internet]. 2018;5(1):11–8. Available from: https://doi.org/10.1177/2049936117727497%0A
  15. Baggs J, Jernigan JA, Halpin AL, Lauren H, Hatfield KM, McDonald LC. Risk of Subsequent Sepsis within 90 Days of a Previous Hospital Stay by Type of Antibiotic Exposure. Clin Infect Dis [Internet]. 2018;66(7):1004–12. Available from: https://doi.org/10.1093/cid/cix947
  16. Bennett E, VanBuren J, Holubkov R, Bratton SL. Presence of Invasive Devices and Risks of Healthcare-Associated Infections and Sepsis. J Pediatr Intensive Care [Internet]. 2018;07(04):188–95. Available from: https://doi.org/10.1055/s-0038-1656535.
  17. Falcone M, Russo A, Giannella M, Cangemi R, Scarpellini MG, Bertazzoni G, et al. Individualizing risk of multidrug-resistant pathogens in community-onset pneumonia. PLoS One [Internet]. 2015;10(4):1–16. Available from: https://doi.org/10.1371/journal.pone.0119528
  18. Marchaim D, Gottesman T, Schwartz O, Korem M, Maor Y, Rahav G, et al. National multicenter study of predictors and outcomes of bacteremia upon hospital admission caused by Enterobacteriaceae producing extended-spectrum ?-lactamases. Antimicrob Agents Chemother [Internet]. 2010;54(12):5099–104. Available from: https://doi.org/10.1128/AAC.00565-10
  19. Capsoni N, Bellone P, Aliberti S, Sotgiu G, Pavanello D, Visintin B, et al. Prevalence, risk factors and outcomes of patients coming from the community with sepsis due to multidrug resistant bacteria. Multidiscip Respir Med [Internet]. 2019;14(23):1–11. Available from: https://doi.org/10.1186/s40248-019-0185-4
  20. Johnson SW, Anderson DJ, May BD, Drew RH. Utility of a Clinical Risk Factor Scoring Model in Predicting Infection with Extended-Spectrum ? -Lactamase-Producing Enterobacteriaceae on Hospital Admission. Infect Control Hosp Epidemiol [Internet]. 2013;34(4):385–92. Available from: http://www.jstor.org/stable/10.1086/669858

How to Cite

Natadidjaja, R. I., Kusuma, A. S., Sudradjad, G. B., & Nugrohowati, L. (2021). The Association between Medical History-based Risks and Sepsis Events in Immunocompromised Patients according to Type III Stratification of the Indonesian Regulation on the Prospective Antimicrobial System (Regulasi Antimikroba Sistem Prospektif / RASPRO). Bali Medical Journal, 10(3), 1031–1036. https://doi.org/10.15562/bmj.v10i3.2561

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Ronald Irwanto Natadidjaja
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Armi Setia Kusuma
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Gede Bangun Sudradjad
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Lies Nugrohowati
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