Factores de riesgo para bacteriemia adquirida en el hospital por Pseudomonas aeruginosa resistente a carbapenémicos en un hospital colombiano

Valderrama, StefanyaSandra Liliana; González, Pedro Felipe; Alejandra, María; Ardila, Natalia; Ariza, Beatriz; Gil, Fabián

doi:10.7705/biomedica.v36i2.2784

Cited by 13 publications

(15 citation statements)

References 34 publications

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“…Our study also found an independent association between total parenteral nutrition and XDR-PA infections. Similar to previous findings, parenteral nutrition was shown to be associated with the acquisition of MDRPA [ 33 ] or bacteremia due to CRPA [ 34 ]. However, in contrast to previous findings, we found no association of either previous PA colonization or high APACHE II scores with XDR-PA infections [ 14 , 16 , 17 ].…”

Section: Discussionsupporting

confidence: 86%

Epidemiology and risk factors of extensively drug-resistant Pseudomonas aeruginosa infections

et al. 2018

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BackgroundThe incidence of nosocomial infections from extensively drug-resistant Pseudomonas aeruginosa (XDR-PA) has been increasing worldwide. We investigated the prevalence and factors associated with XDR-PA infections, including the factors that predict mortality.MethodsWe retrospectively studied a cohort of adult, hospitalized patients with P. aeruginosa (PA) infections between April and December 2014.ResultsOf the 255 patients with PA infections, 56 (22%) were due to XDR-PA, 32 (12.5%) to multidrug resistant Pseudomonas aeruginosa (MDR-PA), and 167 (65.5%) to non-MDR PA. Receiving total parenteral nutrition (adjusted OR [aOR] 6.21; 95% CI 1.05–36.70), prior carbapenem use (aOR 4.88; 95% CI 2.36–10.08), and prior fluoroquinolone use (aOR 3.38; 95% CI 1.44–7.97) were independently associated with the XDR-PA infections. All XDR-PA remained susceptible to colistin. Factors associated with mortality attributable to the infections were the presence of sepsis/septic shock (aOR 11.60; 95% CI 4.66–28.82), admission to a medical department (aOR 4.67; 95% CI 1.81–12.06), receiving a central venous catheter (aOR 3.78; 95% CI 1.50–9.57), and XDR-PA infection (aOR 2.73; 95% CI 1.05–7.08).ConclusionThe prevalence of XDR-PA infections represented almost a quarter of Pseudomonas aeruginosa hospital-acquired infections and rendered a higher mortality. The prompt administration of an appropriate empirical antibiotic should be considered when an XDR-PA infection is suspected.

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Section: Discussionsupporting

confidence: 86%

Epidemiology and risk factors of extensively drug-resistant Pseudomonas aeruginosa infections

et al. 2018

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“…found no correlations between the presence of class I integron and MDR in clinical P. aeruginosa strains. Other studies have shown that P. aeruginosa isolates from patients with a history of long antimicrobial treatment developed MDR/XDR; long hospital stay and readmission to the Intensive Care Unit were associated with MDR in patients with bacteremia caused by this species 41 , 42 .…”

Section: Discussionmentioning

confidence: 97%

Virulence factors and integrons are associated with MDR and XDR phenotypes in nosocomial strains of Pseudomonas aeruginosa in a Venezuelan university hospital

Rodulfo

Arcia

Hernández

et al. 2019

Rev. Inst. Med. trop. S. Paulo

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Multidrug resistance (MDR), virulence and transferable elements potentiate Pseudomonas aeruginosa 's role as an opportunistic pathogen creating a high risk for public health. In this study, we evaluated the possible association of multidrug resistance, virulence factors and integrons with intrahospital P. aeruginosa strains isolated from patients at Cumana hospital, Venezuela. Relevant clinical-epidemiological data were collected to study 176 strains (2009-2016) isolated from different hospital units. Bacterial resistance was classified as susceptible, low-level resistant (LDR), multidrug resistant (MDR) and extensively drug-resistant (XDR). Most strains produced pyoverdine, DNase, gelatinase and hemolysin. Around 73% of the strains showed some type of movement. MDR and XDR strains increased from 2009 (24.2% and 4.8%, respectively) to 2016 (53.1% and 18.8%); while LDR decreased from 64.5% to 6.3%. The exo U and exo S genes were found in a significant number of strains (38.1 and 7.4%, respectively). Class I integrons were detected in 35.8% of the strains and the frequency was associated with resistance (42.9, 22.4, 41.4 and 61.9%, for susceptible, LDR, MDR and XDR, respectively). The MDR/XDR strains were positively associated with hemolysins and exo U, but negatively associated with bacterial twitching. MDR/XDR phenotypes were also associated with the Intensive Care Unit (ICU), septicemia, bronchial infection and diabetic foot ulcers, as well as long hospital stay (≥10 days) and previous antimicrobial treatment. High frequency of MDR/XDR strains and their association with class I integrons and virulence factors can increase the infection potential, as well as morbidity and mortality of patients attending this hospital and could spread infection to the community, creating a health risk for the region.

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“…8 Although transmission of resistant strains and also the spread of resistance via plasmids are not refuted by this current study, these data were based on prefectural units and the mode of spread was not separately captured from the dataset. Similarly, the use of medical devices including intravenous catheters 6,9–11 was not captured in this current study’s dataset, and if such datasets were collected at greater resolution (e.g. by hospital or by hospital ward), associations between these risk factors and P. aeruginosa resistance in Japan could be analysed.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 Epidemiological studies have identified several risk factors for carbapenem-resistant P. aeruginosa infection including use of medical devices, such as artificial respirators and central intravenous catheters, and admission to an intensive care unit with carbapenem use. 6,9–11…”

Section: Introductionmentioning

confidence: 99%

Carbapenem-resistant Pseudomonas aeruginosa and carbapenem use in Japan: an ecological study

Terahara

Nishiura

2019

J Int Med Res

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Objective This study focused on carbapenem resistance in Pseudomonas aeruginosa and examined potential ecological correlations with carbapenem use in Japan. Methods The proportion of carbapenem-resistant P. aeruginosa isolates from 2015 and 2016 by prefecture was obtained from the Japan Nosocomial Infections Surveillance system. Data on carbapenem use was obtained from the National Database of Health Insurance Claims. The correlation between the proportion of carbapenem-resistant isolates and carbapenem consumption was assessed in a cross-sectional manner. The study also collected information on other variables including the numbers of physicians, nurses and medical facilities per 100 000 individuals by prefecture. Results Both the proportion of carbapenem-resistant P. aeruginosa isolates and levels of carbapenem use were higher in western Japan. Using a multivariate model, only carbapenem use remained significantly associated with the proportion of carbapenem-resistant isolates. Conclusions Carbapenem use and the proportion of carbapenem-resistant P. aeruginosa isolates were positively correlated. By longitudinal data collection, this approach offers an avenue to establish causal links as the frequency of carbapenem-resistant P. aeruginosa isolates starts to change in the future.

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Factores de riesgo para bacteriemia adquirida en el hospital por Pseudomonas aeruginosa resistente a carbapenémicos en un hospital colombiano

Cited by 13 publications

References 34 publications

Epidemiology and risk factors of extensively drug-resistant Pseudomonas aeruginosa infections

Epidemiology and risk factors of extensively drug-resistant Pseudomonas aeruginosa infections

Virulence factors and integrons are associated with MDR and XDR phenotypes in nosocomial strains of Pseudomonas aeruginosa in a Venezuelan university hospital

Carbapenem-resistant Pseudomonas aeruginosa and carbapenem use in Japan: an ecological study

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