High Prevalence of Multidrug-Resistant Nonfermenters in Hospital-acquired Pneumonia in Asia

Chung, Doo Ryeon; Song, Jae Hoon; Kim, So Hyun; Thamlikitkul, Visanu; Huang, Shao Guang; Wang, Hui; So, Thomas; Yasin, Rohani Md; Hsueh, Po-Ren; Carlos, Celia C.; Hsu, Li Yang; Buntaran, Latre; Lalitha, M. K.; Kim, Jong Hun; Choi, Jun Yong; Kim, Sang Il; Ko, Kwan Soo; Kang, Cheol In; Peck, Kyong Ran

doi:10.1164/rccm.201102-0349oc

Cited by 272 publications

(253 citation statements)

References 34 publications

Supporting

Mentioning

225

Contrasting

Unclassified

Order By: Relevance

“…These are in-keeping with previous studies (6,9,10,12,13). Underlying diseases, including malignancy, renal disease, immunocompromised status, and hepatic disease, have also been reported as prognostic indicators of hospital mortality (4,10,(14)(15)(16).…”

Section: Discussionsupporting

confidence: 90%

See 1 more Smart Citation

Ventilator-Associated Pneumonia: Epidemiology and Prognostic Indicators of 30-Day Mortality

et al. 2015

View full text Add to dashboard Cite

SUMMARY:We conducted a retrospective cohort study in the medical intensive care unit of Chaing Mai University Hospital to describe the epidemiology of ventilator-associated pneumonia (VAP) and identify prognostic indicators of 30-day VAP mortality. A total of 621 patients diagnosed with VAP between January 2005 and December 2011 were included. The overall 30-day mortality rate was 44.4z. The major causative pathogens were Acinetobacter baumannii (54.3z), Pseudomonas aeruginosa (35.2z), and methicillin-resistant Staphylococcus aureus (15.1z). Most A. baumannii (90.2z) comprised drug-resistant strains. Identified prognostic indicators were co-morbid malignancy (hazard ratio [HR] ＝ 1.60; 95z confidence interval [CI] 1.02-2.42; P ＝ 0.040), septic shock (HR ＝ 2.51; 95z CI, 1.60-4.00; P ＜ 0.001), Simplified Acute Physiology Score II ＞45 (HR ＝ 1.62; 95z CI, 1.03-2.56; P ＝ 0.041), Sequential Organ Failure Assessment score ＞5 (HR ＝ 3.40; 95z CI 2.00-5.81; P ＜ 0.001), and delayed inappropriate empirical antibiotic treatment (HR ＝ 2.23; 95z CI, 1.12-4.45; P ＝ 0.022). VAP was associated with high mortality. The major causative pathogen was drug-resistant A. baumannii. Therefore, early detection of VAP by surveillance in mechanically ventilated patients leading to earlier treatment may improve patient outcomes. Guidelines for prescribing appropriate empirical antibiotics to cover drug-resistant bacteria could be established using local epidemiological data.

show abstract

Section: Discussionsupporting

confidence: 90%

“…A high incidence of XDR-Acinetobacter spp. in Asian countries (51.1z) has been reported (9) without data on PDR-Acinetobacter spp. The incidence of XDR-and PDR-Acinetobacter spp.…”

Section: Discussionmentioning

confidence: 99%

Ventilator-Associated Pneumonia: Epidemiology and Prognostic Indicators of 30-Day Mortality

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Acinetobacter spp. are the seventh most-isolated bacteria in Korean hospitals [15], and they are the most frequent isolates from adults with hospital-acquired pneumonia or ventilator-associated pneumonia in Asian countries, including South Korea [16].…”

Section: Introductionmentioning

confidence: 99%

Old drug, new findings: colistin resistance and dependence of Acinetobacter baumannii

Choi

Lee

2017

Precis Future Med

Self Cite

View full text Add to dashboard Cite

Colistin is an old drug, and its use has recently resurged because of increasing antibiotic resistance in gram-negative bacteria such as Acinetobacter baumannii. Although the colistin resistance rates in gram-negative bacteria are currently not high, many colistin-resistant isolates are being identified and the possibility of horizontal transmission of colistin resistance has increased because of the plasmid-borne colistin resistance gene mcr-1 (mobilized colistin resistance). In this review, we have discussed colistin resistance in A. baumannii. In addition, we have reviewed an abnormal phenomenon called colistin dependence in A. baumannii.

show abstract

“…[3][4][5] Notably, recent trends show an increase in the prevalence of NP caused by multidrug-resistant (MDR) gram-negative bacteria, most commonly Pseudomonas aeruginosa. [6][7][8][9][10] Mortality associated with P. aeruginosa NP (Pa-NP) is among the highest of any bacteria owing to both the virulence of P. aeruginosa as well as the administration of inappropriate initial antibiotic therapy (IIAT) in MDR isolates. [11][12][13][14][15] The escalating prevalence of antibiotic resistance in P. aeruginosa, along with the development and availability of novel antimicrobial therapies, requires a precise understanding of how the various categories of Pa-NP influence outcome.…”

mentioning

confidence: 99%

Pseudomonas aeruginosaNosocomial Pneumonia: Impact of Pneumonia Classification

Micek

Kollef

Torres

et al. 2015

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

OBJECTIVETo describe and compare the mortality associated with nosocomial pneumonia due to Pseudomonas aeruginosa (Pa-NP) according to pneumonia classification (community-onset pneumonia [COP], hospital-acquired pneumonia [(HAP], and ventilator-associated pneumonia [VAP]).DESIGNWe conducted a retrospective cohort study of adults with Pa-NP. We compared mortality for Pa-NP among patients with COP, HAP, and VAP and used logistic regression to identify risk factors for hospital mortality and inappropriate initial antibiotic therapy (IIAT).SETTINGTwelve acute care hospitals in 5 countries (United States, 3; France, 2; Germany, 2; Italy, 2; and Spain, 3).PATIENTS/PARTICIPANTSA total of 742 patients with Pa-NP.RESULTSHospital mortality was greater for those with VAP (41.9%) and HAP (40.1%) compared with COP (24.5%) (P<.001). In multivariate analyses, independent predictors of hospital mortality differed by pneumonia classification (COP: need for mechanical ventilation and intensive care; HAP: multidrug-resistant isolate; VAP: IIAT, increasing age, increasing Charlson comorbidity score, bacteremia, and use of vasopressors). Presence of multidrug resistance was identified as an independent predictor of IIAT for patients with COP and HAP, whereas recent antibiotic administration was protective in patients with VAP.CONCLUSIONSAmong patients with Pa-NP, pneumonia classification identified patients with different risks for hospital mortality. Specific risk factors for hospital mortality also differed by pneumonia classification and multidrug resistance appeared to be an important risk factor for IIAT. These findings suggest that pneumonia classification for P. aeruginosa identifies patients with different mortality risks and specific risk factors for outcome and IIAT.Infect Control Hosp Epidemiol 2015;36(10):1190–1197

show abstract

High Prevalence of Multidrug-Resistant Nonfermenters in Hospital-acquired Pneumonia in Asia

Cited by 272 publications

References 34 publications

Ventilator-Associated Pneumonia: Epidemiology and Prognostic Indicators of 30-Day Mortality

Ventilator-Associated Pneumonia: Epidemiology and Prognostic Indicators of 30-Day Mortality

Old drug, new findings: colistin resistance and dependence of Acinetobacter baumannii

Pseudomonas aeruginosaNosocomial Pneumonia: Impact of Pneumonia Classification

Contact Info

Product

Resources

About