A ROC curve analysis was performed to assess the accuracy of the

A ROC curve analysis was performed to assess the accuracy of the final regression model showing AUC �� SE = 0.79 �� 0.03 with 95% C.I. 0.74 to kinase inhibitor Nilotinib 0.84; Chi Square statistics: P <0.001 (Table (Table4).4). In the 147 patients who received CMS (Table (Table5),5), the likelihood of developing AKI was not significantly different in the CMS and CMS + NA subgroups. In contrast, onset of AKI was two times more likely in patients with a SAPS II score ��43 and six times more likely in those whose infections had presented with septic shock. A ROC curve analysis was performed to assess the accuracy of the final regression model showing AUC �� SE = 0.76 �� 0.04 with 95% CI 0.7 to 0.8; Chi-square statistics P <0.001.

Table 4Logistic regression analysis of factor associated with AKI in the study cohortTable 5Logistic regression analysis of factors associated with AKI in patients who received CMS and CMS/NAs.A similar picture emerged when we analyzed the 222 patients who received CMS alone (n = 90) or NAs alone (n = 132) (Table (Table6).6). The only independent predictors of AKI in this group were SAPS II scores ��44 and septic shock at infection onset. A ROC curve analysis was performed to assess the accuracy of the final regression model showing AUC = 0.8 �� 0.03 with 0.75 to 0.86 95% CI; Chi-square statistics: P <0.01.Table 6Logistic regression analysis of factors associated with AKI in patients who received CMS and NAsThese findings indicate that in ICU patients without pre-existing renal disease who require nephrotoxic antimicrobial drug therapy for XDR bacterial infections, the use of CMS - with or without NAs - does not significantly increase the risk for AKI over that associated with NAs therapy alone.

DiscussionThe cohort treated with high doses of CMS for nosocomial Drug_discovery XDR infections in our study represented approximately 10% of the entire population admitted to the general ICUs during the two-year study period. The overall incidence of AKI in the 279 cases we analyzed was 40%, and there were no significant differences among rates observed in the CMS (34%), CMS+NAs (45%) and NAs subgroups (41%). These data are consistent with the results of the Nefroint study [8], a multicenter study conducted in Italian ICUs: in the subgroup of 133 patients without AKI at ICU admission, the incidence of AKI was 40% regardless of whether or not nephrotoxic drugs were administered. A recent meta-analysis [17] on six controlled studies comparing colistin vs other antibiotics for treatment of VAP in patients without cystic fibrosis suggested that colistin may be as safe as other standard antibiotics used for these drug-resistant infections. In particular, the nephrotoxicity rate for colistin was similar to that in the control group.

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