We retrospectively evaluated whether initial procalcitonin (PCT) levels can predict early antibiotic treatment failure (ATF) in patients with gram-negative bloodstream infections (GN-BSI) caused by urinary tract infections from January 2018 to November 2019. Early ATF was defined as the following: (1) hemodynamically unstable or febrile at Day 3; (2) the need for mechanical ventilation or continuous renal replacement therapy at Day 3; (3) patients who died within 3 days (date of blood culture: Day 0). The study included 189 patients; 42 showed early ATF. Independent risk factors for early ATF were initial admission to the intensive care unit (odds ratio: 7.735, 95% confidence interval: 2.567–23.311; P < 0.001) and PCT levels ≥30 ng/mL (odds ratio: 5.413, 95% confidence interval: 2.188–13.388; P < 0.001). Antibiotic factors were not associated with early ATF. Initial PCT levels may be helpful to predict early ATF in these patients.

我们回顾性评估了初始降钙素原 (PCT) 水平是否可以预测 2018 年 1 月至 2019 年 11 月由尿路感染引起的革兰氏阴性血流感染 (GN-BSI) 患者的早期抗生素治疗失败 (ATF)。早期 ATF 被定义为以下：(1) 第 3 天血流动力学不稳定或发热；(2)第3天需要机械通气或连续肾脏替代治疗；(3) 3天内死亡的患者（血培养日期：第0天）。该研究包括 189 名患者；42显示了早期的ATF。早期 ATF 的独立危险因素是最初入住重症监护病房（优势比：7.735，95% 置信区间：2.567-23.311；P < 0.001）和 PCT 水平 ≥30 ng/mL（优势比：5.413，95% 置信区间）间隔：2.188–13.388；P< 0.001)。抗生素因素与早期 ATF 无关。初始 PCT 水平可能有助于预测这些患者的早期 ATF。