{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T04:56:05Z","timestamp":1788929765167,"version":"build-2803163510"},"reference-count":0,"publisher":"Universiti Sains Malaysia","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Malays J Med Sci"],"abstract":"<jats:p>Background: Hospital-acquired bloodstream infections (BSI) are associated with high morbidity and mortality rates. This study was conducted to describe the outcomes and the prognosis of hospital-acquired BSI in the Critical Care Unit, Hospital Pakar Universiti Sains Malaysia (HPUSM), as well as to identify associated factors of treatment failure and mortality at 28 days. Methods: This prospective cohort study was conducted in the Critical Care Unit of HPUSM from September 2019 to March 2021. Eligible participants included patients with a positive blood culture recorded after 48 hours of admission to hospital. Results: There was a total of 250 patients, whose positive blood cultures were isolated. The main isolated organisms were Klebsiella pneumonia (23.6%), Pseudomonas spp. (19.2%), Escherichia coli (12.8%) and Acinetobacter sp. (9.2%). The mortality of hospital-acquired BSI was 27.6%. Multiple logistic regression analysis revealed that age [adjusted odds ratio (OR) = 1.06; 95% confidence interval (CI): 1.03, 1.09; p &lt; 0.001], cases with extended-spectrum betalactamases (ESBL) (adjusted OR = 5.57; 95% CI: 2.04, 15.21; p = 0.001), with multidrug-resistant (MDR) organisms (adjusted OR = 14.70; 95% CI: 3.97, 54.48; p &lt; 0.001) and those with a sequential organ failure assessment (SOFA) score &gt; 11 (adjusted OR = 4.16; 95% CI: 1.31, 13.19; p = 0.015) had statistically significant associations with treatment failure. Factors significantly associated with 28-day mortality included age (adjusted OR: 1.06: 95% CI; 1.03, 1.09; p &lt; 0.001), MDR organisms (adjusted OR = 14.70; 95% CI: 3.97, 54.48; p &lt; 0.001) and SOFA score &gt; 11 (adjusted OR = 4.16; 95% CI: 1.31, 13.19; p = 0.015). Conclusion: The elderly, ESBL, MDR organisms and high SOFA scores were associated with treatment failure and 28-day mortality in hospital-acquired BSI.<\/jats:p>","DOI":"10.21315\/mjms2024.31.6.13","type":"journal-article","created":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T10:58:42Z","timestamp":1735729122000},"page":"160-177","source":"Crossref","is-referenced-by-count":3,"title":["The Outcome of Hospital-Acquired Bloodstream Infection and Its Associated Factors in Critical Care Unit"],"prefix":"10.21315","volume":"31","author":[{"name":"Department of Anaesthesiology and Intensive Care, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nurul Rahatul Ilyani","family":"Mohamed Shukri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shamsul Kamalrujan","family":"Hassan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Anaesthesiology and Intensive Care, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siti Suraiya","family":"Md Noor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Hospital Pakar Universiti Sains Malaysia, Kelantan, Malaysia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siti Azrin","family":"Ab Hamid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Hospital Pakar Universiti Sains Malaysia, Kelantan, Malaysia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nik Abdullah","family":"Nik Mohamad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Anaesthesiology and Intensive Care, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan Fadzlina","family":"Wan Muhd Shukeri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Anaesthesiology and Intensive Care, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohd Zulfakar","family":"Mazlan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Anaesthesiology and Intensive Care, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"8963","published-online":{"date-parts":[[2024,12,31]]},"container-title":["Malaysian Journal of Medical Sciences"],"original-title":[],"deposited":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T10:58:51Z","timestamp":1735729131000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.mjms.usm.my\/MJMS31062024\/MJMS31062024_13.pdf"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,31]]},"references-count":0,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,12,31]]}},"URL":"https:\/\/doi.org\/10.21315\/mjms2024.31.6.13","relation":{},"ISSN":["2180-4303"],"issn-type":[{"value":"2180-4303","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,31]]}}}