Effect of elevated imipenem/cilastatin minimum inhibitory concentrations on patient outcomes in Gram-negative bloodstream infections
| Autor: | Erik Skoglund, Jamie L. Wagner, Cristina Miglis, Maria R. Advincula, Marc H. Scheetz, Milena M. McLaughlin |
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| Rok vydání: | 2018 |
| Předmět: |
Male
0301 basic medicine Microbiology (medical) medicine.medical_specialty Carbapenem Imipenem 030106 microbiology Immunology Bacteremia Microbial Sensitivity Tests Microbiology 03 medical and health sciences Minimum inhibitory concentration 0302 clinical medicine Internal medicine Bloodstream infection Drug Resistance Bacterial Gram-Negative Bacteria polycyclic compounds Humans Immunology and Allergy Medicine 030212 general & internal medicine Aged Retrospective Studies Gram Cilastatin business.industry Imipenem/cilastatin Middle Aged bacterial infections and mycoses Confidence interval Treatment Outcome Female Gram-Negative Bacterial Infections business medicine.drug |
| Zdroj: | Journal of Global Antimicrobial Resistance. 13:261-263 |
| ISSN: | 2213-7165 |
| DOI: | 10.1016/j.jgar.2018.02.003 |
| Popis: | Carbapenem minimum inhibitory concentration (MICs) are known to predict outcomes for patients with Gram-negative bacteraemia. However, limited data exist on how MICs influence such outcomes when organisms are classified as carbapenem-resistant. The purpose of this study was to evaluate the effect of increasing imipenem/cilastatin MICs on mortality in patients with Gram-negative bloodstream infection (BSI).Patients with an imipenem/cilastatin-resistant (MIC4mg/L) monomicrobial Gram-negative BSI were eligible for inclusion in the study and were assessed for baseline characteristics, organ function, microbiological data, timing and type of therapeutic treatment, and in-hospital mortality.A total of 62 patients with imipenem/cilastatin-resistant bacterial isolates (MIC4mg/L) were retrospectively studied. Time to event analyses found no difference between patients who received carbapenem therapy and those who did not (P=0.10). After adjustment, patients receiving directed therapy were less likely to die (adjusted hazard ratio=0.35, 95% confidence interval 0.15-0.83; P0.01), whereas higher modified Acute Physiology and Chronic Health Evaluation (APACHE) II score and days to positive culture were associated with non-survival.This study did not demonstrate a relationship between receipt of a carbapenem and mortality in patients with carbapenem-resistant Gram-negative BSI. |
| Databáze: | OpenAIRE |
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