| Autor: |
Pilar Hernández-Jiménez, Francisco López-Medrano, Mario Fernández-Ruiz, Jose T. Silva, Laura Corbella, Rafael San-Juan, María Ruiz-Ruigómez, Manuel Lizasoain, Isabel Rodríguez-Goncer, Jazmín Díaz-Regañón, Diego López-Mendoza, Esther Viedma, José María Aguado |
| Jazyk: |
angličtina |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
Journal of Global Antimicrobial Resistance, Vol 29, Iss , Pp 215-221 (2022) |
| Druh dokumentu: |
article |
| ISSN: |
2213-7165 |
| DOI: |
10.1016/j.jgar.2022.03.014 |
| Popis: |
ABSTRACT: Objectives: Multidrug-resistant Pseudomonas aeruginosa (MDR-PSA) constitutes an emerging health problem. A predictive score of MDR-PSA infection would allow an early adaptation of empirical antibiotic therapy. Methods: We performed a single-centre case-control (1:2) retrospective study including 100 patients with MDR-PSA and 200 with a non–MDR-PSA infection. Cases and controls were matched by site of infection, clinical characteristics and immunosuppression. A point risk score for prediction of MDR-PSA infection was derived from a logistic regression model. Secondary outcomes (clinical improvement, complications and discharge) were also compared. Results: Cases with MDR-PSA infection were younger than controls (67.5 vs. 73.0 y; P = 0.031) and have more frequent cirrhosis (9% vs. 2%; P = 0.005). Independent risk factors for MDR-PSA infection were prior antibiotic treatment (80% vs. 50.5%; P < 0.001), prior colonisation with MDR bacteria (41% vs. 13.5%; P < 0.001), hospital-acquired infection (63% vs. 47%; P = 0.009) and septic shock at diagnosis (33% vs. 14%; P < 0.001). Adequate therapy was less frequent in MDR-PSA infections (31% vs. 66.5% for empirical therapy; P < 0.001). The risk score included: previous MDR-PSA isolation (11 points), prior antibiotic use (3 points), hospital-acquired infection (2 points) and septic shock at diagnosis (2 points). It showed an area under the curve of 0.755 (95% CI: 0.70–0.81) and allowed to classify individual risk into various categories: 0–2 points ( |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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Full Text from ScienceDirect