Impact of Multiresistance of Gram-negative Bacteria in Bloodstream Infection on Mortality Rates and Length of Stay

Sostarich, A. M.; Zolldann, Dirk; Haefner, Helga; Luetticken, R.; Schulze-Roebecke, R.; Lemmen, Sebastian

doi:10.1007/s15010-007-6316-4

Cited by 51 publications

(40 citation statements)

References 30 publications

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“…Infections with resistant strains are a major concern because they increase the risk of therapeutic failure [18,19] and are associated with secondary bacteraemia [20] and a considerable increase in mortality, length of hospital stay and overall health costs [9,21,22].…”

Section: Introductionmentioning

confidence: 99%

In vivo development of antimicrobial resistance in Pseudomonas aeruginosa strains isolated from the lower respiratory tract of Intensive Care Unit patients with nosocomial pneumonia and receiving antipseudomonal therapy

Riou

Carbonnelle

Avrain

et al. 2010

International Journal of Antimicrobial Agents

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Section: Introductionmentioning

confidence: 99%

In vivo development of antimicrobial resistance in Pseudomonas aeruginosa strains isolated from the lower respiratory tract of Intensive Care Unit patients with nosocomial pneumonia and receiving antipseudomonal therapy

Riou

Carbonnelle

Avrain

et al. 2010

International Journal of Antimicrobial Agents

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“…It was observed that the Gram-negative bacilli carriers had a high length of stay (mean: 37.2 days). The prolonged length of stay in health institutions and the antimicrobials used may increase the risk of multidrug-resistant microorganisms acquisition [23] [24].…”

Section: Discussionmentioning

confidence: 99%

Epidemiological Characteristics, Resistance Patterns and Spread of Gram-Negative Bacteria Related to Colonization of Patients in Intensive Care Units

Damaceno¹,

Nicoli²,

Oliveira³

2015

AID

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Our aim was to determine the epidemiological characteristics, the resistance patterns and the spread of Gram negative bacteria related to colonization of patients in adult Intensive Care Units. Methods: A prospective cohort of patients colonized and/or infected with Gram negative bacteria was conducted at two adult ICUs from hospitals in Brazil (April 2012 to February 2013). Nasal, groin and perineum swabs were performed. Samples were incubated on MacConkey and cetrimide agar (48 h at 37˚C) and identification tests (Vitek-BioMérieux), antibiogram (Bauer-Kirby method), Carba NP test, Polymerase Chain Reaction (PCR) and sequencing were performed. The patterns of resistant microorganisms were compared by rep-PCR (Diversilab). Results: There were 53 cases of colonization. In these cases, we identified imipenem-resistant Acinetobacter baumannii (51%), Pseudomonas aeruginosa (32%), Klebsiella pneumoniae ESBL (38%) or imipenem resistant (5.6%). The use of antimicrobials and medical devices were related to colonization (p < 0.05). The resistance patterns expressed by Klebsiella pneumoniae were ESBL (CTX-M, SHV e TEM) and KPC2. A verified profile of Acinetobacter baumannii was related to OXA-23 and OXA-253 (OXA-143 variant). The profiles ESBL and KPC2 expressed by Klebsiella pneumoniae were distributed between the both ICUs. The distribution of OXA-23 and OXA-253 was verified only in one ICU. The similarity of strains ranged from 80% to 95%, highlighting the horizontal transference of these microorganisms.

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“…7,[23][24][25][26] However, there are studies showing no significant impact of antibiotic resistance on mortality. 27 FI GU RE 1: Kap lan-Me i er sur vi val es ti ma tes by su i ta bi lity of the tre at ment.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Mortality in Patients with Nosocomial Gram-Negative Bacteremia

Gözel¹,

Erbay²,

Bodur³

et al. 2012

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Nosocomial bloodstream infections are serious health problems in hospitals all over the world. They are associated with a high rate of morbidity and mortality, prolonged hospital stay and higher costs. The aim of this study was to evaluate the clinical outcomes of the patients with gram-negative bacteremia and to identify the risk factors for mortality. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : A prospective observational study was performed in the 1196-bed Ankara Numune Education and Research Hospital. The patients with nosocomial gram-negative bacteremia were included in the study from July 2006 to June 2008. Bacteremia was considered to be nosocomial when it was diagnosed at least 48 h after hospital admission. Gram-negative bacteremia was defined as the presence of gram-negative bacteria in the blood, documented by at least 1 positive hemoculture. In patients who had more than one episode of gram-negative bacteremia, only the first episode was considered. Antibiotic therapy was considered to be appropriate if the drugs used had in vitro activity against the isolated strain. R Re es su ul lt ts s: : Among the 253 cases (mean age: 54.5± 20 years old, male/female: 159/94) of Gram-negative bacteremia included in the study, the most frequently detected microorganisms were Escherichia coli (n=96, 37.9%), Acinetobacter spp. (n=54, 21.33%), Pseudomonas aeruginosa (n=41, 16.2%), Klebsiella spp. (n=39, 15.4%), Enterobacter spp. (n=9, 3.5%) and Stenotrophomonas maltophilia (n=6, 2.3%). The mean duration of hospital stay until Gram-negative bacteremia was 19 ±17 (range 3-82) days. Mortality rates at 14 days and at 30 days after the bacteremia were, respectively, 28.5% and 38.4%. We found that Acute Physiology and Chronic Health Evaluation (APACHE) II score over 20, inappropriate antibiotic treatment, receiving total parenteral nutrition, unconsciousness and thrombocytopenia were significant independent risk factors for mortality at day 30 after the Gramnegative bacteremia. C Co on nc cl lu us si io on n: : Awareness of mortality risk factors is important for the prognosis. Appropriate antibiotic treatment could decrease deaths associated with Gram-negative bacteremia.

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Impact of Multiresistance of Gram-negative Bacteria in Bloodstream Infection on Mortality Rates and Length of Stay

Cited by 51 publications

References 30 publications

In vivo development of antimicrobial resistance in Pseudomonas aeruginosa strains isolated from the lower respiratory tract of Intensive Care Unit patients with nosocomial pneumonia and receiving antipseudomonal therapy

In vivo development of antimicrobial resistance in Pseudomonas aeruginosa strains isolated from the lower respiratory tract of Intensive Care Unit patients with nosocomial pneumonia and receiving antipseudomonal therapy

Epidemiological Characteristics, Resistance Patterns and Spread of Gram-Negative Bacteria Related to Colonization of Patients in Intensive Care Units

Risk Factors for Mortality in Patients with Nosocomial Gram-Negative Bacteremia

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