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Risk factors for antimicrobial resistance and influence of resistance on mortality in patients with bloodstream infection caused by Pseudomonas aeruginosa

Cited 73 time in Web of Science Cited 77 time in Scopus
Authors
Kang, Cheol-In; Kim, Sung-Han; Park, Wan Beom; Lee, Ki-Deok; Kim, Hong-Bin; Kim, Eui-Chong; Oh, Myoung-Don; Choe, Kang-Won
Issue Date
2005-03-17
Publisher
Mary Ann Liebert
Citation
Microb Drug Resist. 2005 Spring;11(1):68-74.
Keywords
AdolescentAdultAgedAnti-Bacterial Agents/*pharmacology/therapeutic useBacteremia/microbiology/*mortalityCiprofloxacin/therapeutic useCiprofloxacin/therapeutic use*Drug Resistance, BacterialFemaleHospital MortalityHumansImipenem/therapeutic useMaleMiddle AgedPseudomonas Infections/drug therapy/epidemiology/microbiology/*mortalityPseudomonas aeruginosa/drug effects/*isolation & purificationRisk Factors
Abstract
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.
ISSN
1076-6294 (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15770098

http://hdl.handle.net/10371/29779
DOI
https://doi.org/10.1089/mdr.2005.11.68
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Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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