Risk factors for pan-resistant Pseudomonas aeruginosa bacteremia and the adequacy of antibiotic therapy

Tuon, Felipe Francisco; Görtz, Lucas Wagner; Rocha, Jaime L.

doi:10.1016/j.bjid.2012.06.009

Cited by 59 publications

(41 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…20 Other studies have identified age as a risk factor for antibiotic-resistant Pseudomonas . 21,22 We found one study that identified anemia as a risk factor for Pseudomonas bacteremia. 23 We found one study that identified neurological disease as a risk factor for antibiotic-resistant Pseudomonas infections.…”

Section: Discussionmentioning

confidence: 96%

Pseudomonas aeruginosa Colonization in the Intensive Care Unit: Prevalence, Risk Factors, and Clinical Outcomes

Harris

Jackson

Robinson

et al. 2016

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

OBJECTIVE Determine the prevalence of Pseudomonas aeruginosa colonization on ICU admission, risk factors for P. aeruginosa colonization, and the incidence of subsequent clinical culture with P. aeruginosa among those colonized and not colonized. DESIGN A cohort study of patients admitted to the medical or surgical intensive care units between January 1, 2013, and December 31, 2013. SETTING A tertiary care hospital in Maryland. RESULTS 213 patients of 1840 patients (11.6%) were colonized with P. aeruginosa on ICU admission. Significant risk factors in the multivariable analysis for colonization were age (OR 1.02, 95% CI 1.01–1.03), anemia (1.90, 95% CI 1.05–3.42) and neurological disease (OR 1.80 95% CI 1.27–2.54). Among the 213 patients colonized with P. aeruginosa on admission, 60 (28.2%) had a subsequent clinical culture positive for P. aeruginosa on the current hospital admission (ICU period and post ICU period). 49 (82%) of the 60 patients had clinical infections. Among those not colonized on admission, only 68 (4.2%) had a subsequent clinical culture positive for P. aeruginosa on the current hospital admission. Patients colonized with P. aeruginosa were more likely to have a subsequent positive clinical culture than patients not colonized (IRR: 6.74, 95% CI: 4.91, 9.25). CONCLUSIONS These data emphasize the need to identify ICU patients colonized with P. aeruginosa on admission. Prediction rules or rapid diagnostic testing will help clinicians more appropriately choose empiric antibiotic therapy for subsequent infections.

show abstract

Section: Discussionmentioning

confidence: 96%

Pseudomonas aeruginosa Colonization in the Intensive Care Unit: Prevalence, Risk Factors, and Clinical Outcomes

Harris

Jackson

Robinson

et al. 2016

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

show abstract

“…En varios estudios contemporáneos se ha evaluado el impacto del uso de ertapenem en la emergencia de microorganismos resistentes y, aunque los resultados son contradictorios, la mayoría de los hallazgos apuntan a que no hay asociación (12,23). En el estudio de Sousa, et al, su empleo se relacionó con un menor uso de imipenem y con la mayor sensibilidad de P. aeruginosa a este medicamento (24 El uso de quinolonas fue otro factor de riesgo estadísticamente significativo en este estudio, al igual que en otras investigaciones y en un metaanálisis (OR=2,73; IC 95% 1,27-5,87) (25).…”

Section: Discussionunclassified

Factores de riesgo para bacteriemia adquirida en el hospital por Pseudomonas aeruginosa resistente a carbapenémicos en un hospital colombiano

et al. 2016

View full text Add to dashboard Cite

Contribución de los autores:Todos los autores participaron en el diseño del estudio, el análisis e interpretación de los resultados, y en la redacción y aprobación del manuscrito. Introducción. Las bacteriemias por Pseudomonas aeruginosa resistentes a carbapenémicos son un problema de salud pública por las pocas alternativas de tratamiento disponibles, el aumento de la estancia hospitalaria, los costos que genera y el aumento en el riesgo de mortalidad. Objetivo. Evaluar los factores de riesgo de bacteriemia por P. aeruginosa resistente a carbapenémicos adquirida en el Hospital Universitario San Ignacio, durante el periodo comprendido entre enero de 2008 y junio de 2014. Materiales y métodos. Se hizo un estudio de casos y controles. Los casos eran de pacientes que presentaban bacteriemia por P. aeruginosa resistente a carbapenémicos y los controles eran pacientes con P. aeruginosa sensible a este grupo de antibióticos. Se midieron variables como el uso de meropenem o ertapenem, la inmunosupresión y la neoplasia, y se determinaron la mortalidad y el tiempo de estancia hospitalaria. Resultados. Se evaluaron 168 pacientes, 42 casos y 126 controles. En el modelo multivariado se encontraron los siguientes factores de riesgo relacionados con la bacteriemia por P. aeruginosa resistente a carbapenémicos y adquirida en el hospital: uso de nutrición parenteral (odds ratio, OR=8,28; IC 95% 2,56-26,79; p=0), uso de meropenem (OR=1,15; IC 95% 1,03-1,28; p=0,01) y uso de ciprofloxacina (OR=81,99; IC 95% 1,14-5884; p=0,043). Conclusión. Para el control de la aparición de P. aeruginosa resistente a carbapenémicos, se deben fortalecer los programas de control de antimicrobianos, promover el uso prudente de carbapenémicos y quinolonas, y vigilar el uso adecuado de la nutrición parenteral. Factores de riesgo para bacteriemia por Pseudomonas aeruginosa resistente a carbapenémicos adquirida en un hospital colombiano Palabras clave:Pseudomonas aeruginosa, factores de riesgo, bacteriemia, nutrición parenteral, ciprofloxacina. doi: http://dx.doi.org/10.7705/biomedica.v36i2.2784Risk factors for hospital-acquired bacteremia due to carbapenem-resistant Pseudomonas aeruginosa in a Colombian hospital Introduction: Bacteremia due to Pseudomonas aeruginosa resistant to carbapenems is a public health problem due to the limitations it places on therapeutic options, as well as the increased time patients must spend in hospital, costs and the risk of mortality. Objective: To evaluate the risk factors for presentation of bacteremia due to carbapenem-resistant P. aeruginosa acquired in the Hospital Universitario San Ignacio between January 2008 and June 2014. Materials and methods: This was a case control study in which the case patients presented bacteremia due to P. aeruginosa resistant to carbapenems and the control group included patients with P. aeruginosa susceptible to this group of antibiotics. Variables such as the previous use of meropenem and ertapenem, immunosuppression and neoplasia were measured. Mortality and duration of hospital wer...

show abstract

“…Other studies have found that 30-day mortality in these patients may be as high as 40%. 15,22 PAS has been associated with higher mortality rates than septicemia caused by other pathogens. One study found that the in-hospital mortality rate was 16% for all septicemiarelated hospital stays.…”

Section: Discussionmentioning

confidence: 99%

Shifting trends in the incidence of Pseudomonas aeruginosa septicemia in hospitalized adults in the United States from 1996-2010

Werth¹,

Carreno²,

Reveles³

2015

American Journal of Infection Control

View full text Add to dashboard Cite

Risk factors for pan-resistant Pseudomonas aeruginosa bacteremia and the adequacy of antibiotic therapy

Abstract: Appropriate treatment for CS-PA bacteremia initiated within the first 24 hours was associated with lower mortality, but this cannot be extrapolated for CR-PA.

Cited by 59 publications

References 21 publications

Pseudomonas aeruginosa Colonization in the Intensive Care Unit: Prevalence, Risk Factors, and Clinical Outcomes

Pseudomonas aeruginosa Colonization in the Intensive Care Unit: Prevalence, Risk Factors, and Clinical Outcomes

Factores de riesgo para bacteriemia adquirida en el hospital por Pseudomonas aeruginosa resistente a carbapenémicos en un hospital colombiano

Shifting trends in the incidence of Pseudomonas aeruginosa septicemia in hospitalized adults in the United States from 1996-2010

Contact Info

Product

Resources

About