Factors associated with epidemic multiresistant Pseudomonas aeruginosa infections in a hospital with AIDS-predominant admissions

Gomes, Marisa Zenaide Ribeiro; Oliveira, Raquel de Vasconcellos Carvalhaes de; Machado, Carolina Romero; Conceição, Magda de Souza da; Souza, Cristina Vieira; Lourenço, Maria Cristina da Silva; Asensi, Marise Dutra

doi:10.1590/s1413-86702012000300001

Cited by 9 publications

(11 citation statements)

References 30 publications

(74 reference statements)

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“…Our study also found an independent association between total parenteral nutrition and XDR-PA infections. Similar to previous findings, parenteral nutrition was shown to be associated with the acquisition of MDRPA [ 33 ] or bacteremia due to CRPA [ 34 ]. However, in contrast to previous findings, we found no association of either previous PA colonization or high APACHE II scores with XDR-PA infections [ 14 , 16 , 17 ].…”

Section: Discussionsupporting

confidence: 85%

Epidemiology and risk factors of extensively drug-resistant Pseudomonas aeruginosa infections

et al. 2018

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BackgroundThe incidence of nosocomial infections from extensively drug-resistant Pseudomonas aeruginosa (XDR-PA) has been increasing worldwide. We investigated the prevalence and factors associated with XDR-PA infections, including the factors that predict mortality.MethodsWe retrospectively studied a cohort of adult, hospitalized patients with P. aeruginosa (PA) infections between April and December 2014.ResultsOf the 255 patients with PA infections, 56 (22%) were due to XDR-PA, 32 (12.5%) to multidrug resistant Pseudomonas aeruginosa (MDR-PA), and 167 (65.5%) to non-MDR PA. Receiving total parenteral nutrition (adjusted OR [aOR] 6.21; 95% CI 1.05–36.70), prior carbapenem use (aOR 4.88; 95% CI 2.36–10.08), and prior fluoroquinolone use (aOR 3.38; 95% CI 1.44–7.97) were independently associated with the XDR-PA infections. All XDR-PA remained susceptible to colistin. Factors associated with mortality attributable to the infections were the presence of sepsis/septic shock (aOR 11.60; 95% CI 4.66–28.82), admission to a medical department (aOR 4.67; 95% CI 1.81–12.06), receiving a central venous catheter (aOR 3.78; 95% CI 1.50–9.57), and XDR-PA infection (aOR 2.73; 95% CI 1.05–7.08).ConclusionThe prevalence of XDR-PA infections represented almost a quarter of Pseudomonas aeruginosa hospital-acquired infections and rendered a higher mortality. The prompt administration of an appropriate empirical antibiotic should be considered when an XDR-PA infection is suspected.

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Section: Discussionsupporting

confidence: 85%

Epidemiology and risk factors of extensively drug-resistant Pseudomonas aeruginosa infections

et al. 2018

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“…The literature search identified a total of 165 citations; of which, 98 full-text articles were retrieved and assessed for eligibility. The systematic review included 19 articles (6 articles for AIAT versus IIAT [12][13][14][15][16][17]; 17 articles for acquisition of resistant or multidrug-resistant P. aeruginosa [12,[14][15][16][18][19][20][21][22][23][24][25][26][27][28][29][30] and 4 articles reported both outcomes [12,[14][15][16]) that met final eligibility criteria ( Fig. 1).…”

Section: Baseline Study and Population Characteristicsmentioning

confidence: 99%

“…Nineteen studies reported in 17 articles (two articles contributed to four studies) were included (Table 3) [12,[14][15][16][18][19][20][21][22][23][24][25][26][27][28][29][30]. A total of 3203 total subjects (1077 cases and 2126 controls) were examined for risk factors of acquisition of [29]).…”

Section: Risk Factors For Acquiring Resistant P Aeruginosamentioning

confidence: 99%

Pseudomonas infections among hospitalized adults in Latin America: a systematic review and meta-analysis

et al. 2020

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Background: Treatment of resistant Pseudomonas aeruginosa infection continues to be a challenge in Latin American countries (LATAM). We synthesize the literature on the use of appropriate initial antibiotic therapy (AIAT) and inappropriate initial antibiotic therapy (IIAT) in P. aeruginosa infections, and the literature on risk factors for acquisition of resistant P. aeruginosa among hospitalized adult patients in LATAM.Methods: MEDLINE, EMBASE, Cochrane, and LILAC were searched between 2000 and August 2019. Abstracts and full-text articles were screened in duplicate. Random effects meta-analysis was conducted when studies were sufficiently similar.Results: The screening of 165 citations identified through literature search yielded 98 full-text articles that were retrieved and assessed for eligibility, and 19 articles conducted in Brazil (14 articles), Colombia (4 articles), and Cuba (1 article) met the inclusion criteria. Of 19 eligible articles, six articles (840 subjects) examined AIAT compared to IIAT in P. aeruginosa infections; 17 articles (3203 total subjects) examined risk factors for acquisition of resistant P. aeruginosa; and four articles evaluated both. Four of 19 articles were rated low risk of bias and the remaining were deemed unclear or high risk of bias. In meta-analysis, AIAT was associated with lower mortality for P. aeruginosa infections (unadjusted summary OR 0.48, 95% CI 0.28-0.81; I 2 = 59%), compared to IIAT and the association with mortality persisted in subgroup meta-analysis by low risk of bias (3 articles; unadjusted summary OR 0.46, 95% CI 0.28-0.81; I 2 = 0%). No meta-analysis was performed for studies evaluating risk factors for acquisition of resistant P. aeruginosa as they were not sufficiently similar. Significant risk factors for acquisition of resistant P. aeruginosa included: prior use of antibiotics (11 articles), stay in the intensive care unit (ICU) (3 articles), and comorbidity score (3 articles). Outcomes were graded to be of low strength of evidence owing to unclear or high risk of bias and imprecise estimates. Conclusion:Our study highlights the association of AIAT with lower mortality and prior use of antibiotics significantly predicts acquiring resistant P. aeruginosa infections. This review reinforces the need for rigorous and structured antimicrobial stewardship programs in the LATAM region.

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“…Many strains of staphylococci, Enterobacteriaceae, and enterococci are currently resistant to most or all antimicrobials which were once e ective [17,18]. Moreover, multi-resistant Klebsiella spp, P. aeruginosa, A. baumannii, and C. di cile are prevalent in many hospitals [17,[19][20][21][22][23]. ese pathogens are able to evade the e ects of antibiotics through a signi cant number of mechanisms, compromising the e ective treatment of infections.…”

Section: Antimicrobial Resistance and Virulencementioning

confidence: 99%

High-throughput genomic technology in research of virulence and antimicrobial resistance in microorganisms causing nosocomial infections

Silva¹,

Igrejas²,

Poeta

2014

JIOMICS

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Most hospital-acquired infections are caused by organisms common in the general population and most are relatively harmless. Infection by nosocomial pathogenic bacteria is increasingly becoming a major threat to hospital patients. Molecular diagnosis of antibiotic resistant organisms such as Clostridium di cile Infections (CDI) Methicillin Resistant Staphylococcus aureus (MRSA), Extended-Spectrum β-lactamase (ESBL) Escherichia coli, Vancomycin Resistant Enterococcus (VRE), Carbapenem-Resistant Klebsiella (CRK), among others, is vital for prevention of healthcare-acquired infections in acute care facilities. DNA microarray besides being a promising diagnosis tool may also provide valuable information about the mechanisms of antimicrobial resistance and pathogenicity of these bacteria. is review aims to highlight the prominence of high-throughput genomic tools in research of virulence and antimicrobial resistance in microorganisms causing nosocomial infections.

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Factors associated with epidemic multiresistant Pseudomonas aeruginosa infections in a hospital with AIDS-predominant admissions

Cited by 9 publications

References 30 publications

Epidemiology and risk factors of extensively drug-resistant Pseudomonas aeruginosa infections

Epidemiology and risk factors of extensively drug-resistant Pseudomonas aeruginosa infections

Pseudomonas infections among hospitalized adults in Latin America: a systematic review and meta-analysis

High-throughput genomic technology in research of virulence and antimicrobial resistance in microorganisms causing nosocomial infections

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