Colistin nephrotoxicity in the ICU: Is it different in the geriatric patients?

Abstract

In our study, in geriatric patient group colistin nephrotoxicity was not different from the younger age group. In the ICU, the age for nephrotoxicity does not appear to be a point to be considered for the initiation of colistin.

Factors affecting colistin nephrotoxicity: Advanced age and/or other factors?

“…Although some studies demonstrated higher mortality in patients with COL nephrotoxicity, others showed no difference (3,19,20).Özkarakaş et al reported similar mortality rates between patients with and without nephrotoxicity (19). In another study comparing mortality rates in older and young adult patients receiving COL, there was no difference between the two groups (5). In contrast to these findings, mortality rates were statistically higher in the nephrotoxicity group and in the geriatric nephrotoxicity subgroup in our study.…”

“…Aydogan et al reported higher rates of cardiac disease and COPD in the geriatric group but it was found that advanced age is not a risk factor for nephrotoxicity. (5). In our study, no significant difference was found between geriatric and young patients who developed nephrotoxicity in terms of underlying chronic diseases, concomitant nephrotoxic agent use, initial serum urea and creatinine values.…”

“…Being treated in intensive care units (ICUs) and older age are factors that increase the frequency of infections caused by resistant microorganisms and complicate the management of the antimicrobial agents used. Some studies have shown that COL nephrotoxicity increases with age, while no relationship between age and COL-related renal toxicity was detected in others (5)(6)(7)(8)(9). The present study aimed to identify risk factors associated with COL nephrotoxicity in the general population and geriatric patients hospitalized in the ICUs of our hospital.…”

“…One of these studies showed that nephrotoxicity frequently occurred in the first 72 hours after starting COL (7). In another study investigating COL nephrotoxicity in older and younger adult patients, it was observed that older patients had a significantly longer length of ICU stay before COL initiation (5). When geriatric and young patients were compared in terms of time from onset of COL to nephrotoxicity, there was no statistically significant difference.…”

Complete Genome and Plasmid Sequences of Seven Isolates of Salmonella enterica subsp. enterica Harboring the mcr-1 Gene Obtained from Food in China

“…The rise and dissemination of multidrug-resistant (MDR) Enterobacteriaceae, especially carbapenem-resistant Enterobacteriaceae (CRE), with mechanisms such as NDM-1, KPC, and OXA-48/181 in the last few decades have led to urgent challenges in the clinical treatment of MDR or extensively drug-resistant (XDR) pathogen diseases (1, 2). In this case, despite having a side effect of nephrotoxicity, colistin is still considered a last-resort antibiotic in the clinical treatment of serious infections caused by CRE (3). However, mobile colistin resistance (MCR), referring to a plasmid-mediated gene encoding a phosphoethanolamine transferase conferring resistance to colistin, was initially reported in 2015 in China and named mcr-1 ( m obile c olistin r esistance 1) (4).…”