High Prevalence of Multidrug-Resistant Nonfermenters in Hospital-acquired Pneumonia in Asia
| Autor: | Min Ja Kim, Shao-Guang Huang, Kyong Ran Peck, Visanu Thamlikitkul, Doo Ryeon Chung, Po-Ren Hsueh, Kwan Soo Ko, M. K. Lalitha, Rohani Md Yasin, Celia C. Carlos, Jun Yong Choi, Li Yang Hsu, Hui Wang, Cheol-In Kang, Latre Buntaran, Sang Il Kim, Jae-Hoon Song, So Hyun Kim, Thomas Man-kit So |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Imipenem Asia Comorbidity Drug resistance Critical Care and Intensive Care Medicine Hospital-acquired pneumonia medicine.disease_cause Microbiology Antibiotic resistance stomatognathic system Risk Factors Drug Resistance Multiple Bacterial Pneumonia Bacterial Prevalence medicine Humans Prospective Studies Aged Aged 80 and over Cross Infection Acinetobacter biology business.industry Pseudomonas aeruginosa Pneumonia Ventilator-Associated Middle Aged medicine.disease biology.organism_classification Anti-Bacterial Agents respiratory tract diseases Multiple drug resistance Klebsiella pneumoniae Pneumonia Multivariate Analysis Female business medicine.drug |
| Zdroj: | American Journal of Respiratory and Critical Care Medicine. 184:1409-1417 |
| ISSN: | 1535-4970 1073-449X |
| DOI: | 10.1164/rccm.201102-0349oc |
| Popis: | Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) remain important causes of morbidity and mortality. Increasing antimicrobial resistance has aroused the concern of the failure of antibiotic treatment.To determine the distribution of the bacterial isolates of HAP and VAP, their antimicrobial resistance patterns, and impact of discordant antibiotic therapy on clinical outcome in Asian countriesA prospective surveillance study was conducted in 73 hospitals in 10 Asian countries from 2008-2009. A total of 2,554 cases with HAP or VAP in adults were enrolled and 2,445 bacterial isolates were collected from 1,897 cases. Clinical characteristics and antimicrobial resistance profiles were analyzed.Major bacterial isolates from HAP and VAP cases in Asian countries were Acinetobacter spp., Pseudomonas aeruginosa, Staphylococcus aureus, and Klebsiella pneumoniae. Imipenem resistance rates of Acinetobacter and P. aeruginosa were 67.3% and 27.2%, respectively. Multidrug-resistant rates were 82% and 42.8%, and extensively drug-resistant rates were 51.1% and 4.9%. Multidrug-resistant rate of K. pneumoniae was 44.7%. Oxacillin resistance rate of S. aureus was 82.1%. All-cause mortality rate was 38.9%. Discordant initial empirical antimicrobial therapy increased the likelihood of pneumonia-related mortality (odds ratio, 1.542; 95% confidence interval, 1.127-2.110).Acinetobacter spp., P. aeruginosa, S. aureus, and K. pneumoniae are the most frequent isolates from adults with HAP or VAP in Asian countries. These isolates are highly resistant to major antimicrobial agents, which could limit the therapeutic options in the clinical practice. Discordant initial empirical antimicrobial therapy significantly increases the likelihood of pneumonia-related mortality. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|