Influence of carbapenem resistance on mortality and the dynamics of mortality in Pseudomonas aeruginosa bloodstream infection
| Autor: | Adriana Manzur, Miquel Pujol, Francesc Gudiol, Fe Tubau, Cristina Suárez, Laura Gavaldà, M. Angeles Domínguez, Carmen Peña, Javier Ariza |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male Microbiology (medical) medicine.medical_specialty Mortality dynamics Adolescent Carbapenem resistance medicine.drug_class Antibiotics Bacteremia Kaplan-Meier Estimate Drug resistance Biology medicine.disease_cause beta-Lactam Resistance Microbiology Sepsis Young Adult Risk Factors Internal medicine medicine Humans Pseudomonas Infections Survival analysis Aged Retrospective Studies Aged 80 and over Pseudomonas aeruginosa Health Policy Retrospective cohort study General Medicine Odds ratio Middle Aged bacterial infections and mycoses medicine.disease Anti-Bacterial Agents Treatment Outcome Infectious Diseases Carbapenems Spain Female Therapy |
| Zdroj: | International Journal of Infectious Diseases. 14:e73-e78 |
| ISSN: | 1201-9712 |
| DOI: | 10.1016/j.ijid.2009.11.019 |
| Popis: | Objective We aimed to study the influence of carbapenem resistance on attributable mortality in a cohort of patients with Pseudomonas aeruginosa bacteremia. Methods Data on 121 episodes of P. aeruginosa bacteremia occurring between January and December 2005 were retrospectively analyzed. Results Thirty-three episodes were caused by carbapenem-resistant P. aeruginosa (CRPA) strains and 88 by carbapenem-susceptible P. aeruginosa (CSPA) strains. There was no significant difference in mortality between the groups (33% in CRPA vs. 30% in CSPA; p = 0.69). However, a Kaplan–Meier survival analysis showed that in the first 48h after the onset of bacteremia, there was a lower cumulative mortality proportion in the CRPA group than in the CSPA group (13% vs. 50%; p = 0.026). The independent risk factors associated with death in P. aeruginosa bacteremia were clinical presentation with severe sepsis (odds ratio (OR) 38, 95% confidence interval (CI) 10.2–142.2) and bacteremia of high-risk origin (OR 6.6, 95% CI 1.6–26.9). Conclusions According to our data, carbapenem resistance was not associated with higher mortality in patients with P. aeruginosa bacteremia. The slower initial mortality in the CRPA group might have implications in the design of the optimal antibiotic policy strategy. |
| Databáze: | OpenAIRE |
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