Pseudomonas aeruginosa infections: factors relating to mortality with emphasis on resistance pattern and antimicrobial treatment

Abstract

A retrospective case-control study was conducted to investigate the risk factors for death among intensive care unit patients with Pseudomonas aeruginosa infection. Out of 131 patients investigated, 67 (51.1%) died within 30 days of being diagnosed with this infection. The mean duration of hospital stay before this diagnosis was 28.5 ± 26.5 days. No association was found between bacterial resistance and death in this study (multiresistant p= 0.26; panresistant p= 0.42), but the adequacy of the initial treatment was inversely proportional to the degree of resistance. There was a tendency towards greater mortality among patients who received combination therapy (empirical p= 0.09; definitive p= 0.08), despite the greater frequency of appropriate treatment in these patients and the similar degree of severity in the two groups. This finding may be explained by pharmacodynamic parameters that were not studied or by the extensive use of aminoglycosides in the combination therapy, which play a controversial role in combination therapy due to their potential for renal toxicity. The multivariate analysis in our study demonstrated that age [odds ratio (OR) 1.04], septic shock (OR 15.4) and hypoalbuminemia (OR 0.32) were independent risk factors for death.

Retrospective Analysis of Antibiotic Susceptibility Patterns of Respiratory Isolates of Pseudomonas Aeruginosa in a Chest Diseases Public Hospital

“…This rate was reported as 51.1% in the study of Pinheiro et al (27) and 25.2% in the study of Joo et al (31). The reason for lower mortality in our study than in other studies is that those studies were conducted among intensive care patients or patients with bacteremia.…”

“…In this study, IMP resistance was found to be 21.8%. IMP resistance is reported to vary between 16.8% and 54% in studies conducted in Turkey (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) and between 7% and 37.4% in foreign studies (22,27). High resistance rates were detected in studies on intensive care patients ( Table 8).…”

Association between infections caused by multidrug-resistant gram-negative bacteria and mortality in critically ill patients

“…Positive association with increased hospital mortality Daniels et al [40] Retrospective, propensitymatched cohort study [42] Retrospective case-control study 131 …”

Distribution of the type III effector proteins-encoding genes among nosocomial Pseudomonas aeruginosa isolates from Bulgaria

“…Pseudomonas aeruginosa is a major cause of hospitalacquired infections and the most significant pulmonary pathogen in cystic fibrosis patients (Pinheiro et al 2008;Rajan and Saiman 2002). P. aeruginosa is responsible for 10-15% of nosocomial infections worldwide (Blanc et al 1998).…”