Risk Factors for Antimicrobial Resistance and Influence of Resistance on Mortality in Patients with Bloodstream Infection Caused by Pseudomonas aeruginosa
This study was conducted to evaluate risk factors for antimicrobial resistance and influence of resistance on mortality in Pseudomonas aeruginosa bacteremia. Data on 190 patients with P. aeruginosa bacteremia were analyzed retrospectively. Antimicrobial resistance to antipseudomonal antibiotics was...
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Published in | Microbial drug resistance (Larchmont, N.Y.) Vol. 11; no. 1; pp. 68 - 74 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Mary Ann Liebert, Inc
01.03.2005
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Subjects | |
Online Access | Get full text |
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Summary: | This study was conducted to evaluate risk factors for antimicrobial resistance and influence of resistance on mortality in
Pseudomonas aeruginosa
bacteremia. Data on 190 patients with
P. aeruginosa
bacteremia were analyzed retrospectively. Antimicrobial resistance to antipseudomonal antibiotics was evaluated. The main outcome measure was 30-day mortality. In
P. aeruginosa
bacteremia, resistance rates to piperacillin (PIP), ceftazidime (CAZ), ciprofloxacin (CIP), and imipenem (IPM) were 29 (56/190), 19 (36/190), 17 (32/190) and 15% (28/190), respectively. Prior uses of fluoroquinolones or carbapenems were independent risk factors for resistance to CIP and IPM, and prior use of extended-spectrum cephalosporins was a risk factor for PIP-R. An indwelling urinary catheter was a risk factor for PIP-R, CAZ-R, and CIP-R. An invasive procedure was a risk factor for CIP-R and IPM-R. The 30-day mortality rate was 44% (33/75) in patients infected by strains resistant to any of the antipseudomonal antibiotics, but 33.9% (39/115) in those by strains susceptible to all
antipseudomonal antibiotics (
p
= 0.161). Among patients with bloodstream infection due to antimicrobial-resistant
P. aeruginosa
, those infected by IPM-R strains had the highest mortality (IPM-R, 53.6% vs. CAZ-R, 47.2% vs. CIP-R 46.9%, PIP-R, 39.3%). In this study regarding
P. aeruginosa
bacteremia, prior uses of fluoroquinolones, carbapenems, or extended-spectrum cephalosporins, a prior invasive procedure, and an indwelling urinary catheter were found to be associated with antimicrobial resistance. The patients with bloodstream infection caused by antimicrobial-resistant
P. aeruginosa
, especially to imipenem, had a tendency toward higher mortality than those infected by susceptible strains. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1076-6294 1931-8448 |
DOI: | 10.1089/mdr.2005.11.68 |