Please use this identifier to cite or link to this item: http://hdl.handle.net/10668/2004
Título : Prospective multicenter study of the impact of carbapenem resistance on mortality in Pseudomonas aeruginosa bloodstream infections.
Autor : Peña, Carmen
Suarez, Cristina
Gozalo, Mónica
Murillas, Javier
Almirante, Benito
Pomar, Virginia
Aguilar, Manuela
Granados, Ana
Calbo, Esther
Rodríguez-Baño, Jesús
Rodríguez, Fernando
Tubau, Fe
Martínez-Martínez, Luis
Oliver, Antonio
Filiación: [Peña,C; Suarez,C; Tubau,F] Servicio de Enfermedades Infecciosas, Hospital Universitario de Bellvitge-IDIBELL, Barcelona, Spain. [Gozalo,M; Martínez-Martínez,L] Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla-IFIMAV, Santander, Spain. [Murillas,J; Oliver,A] Servicio de Medicina Interna-Infecciosas y Microbiología, Hospital Universitario de Son Espases, Palma de Mallorca, Spain. [Almirante,B] Servicio de Enfermedades Infecciosas, Hospital Universitario Vall d'Hebrón, Barcelona, Spain. [Pomar,V] Unidad de Enfermedades Infecciosas, Hospital Santa Creu i Sant Pau, Barcelona, Spain. [Aguilar,M] Servicio de Enfermedades Infecciosas, Hospital Universitario Virgen del Rocío, Seville, Spain. [Granados,A] Sección de Enfermedades Infecciosas, Consorci Hospitalari Parc Taulí, Sabadell, Spain. [Calbo,E] Sección de Enfermedades Infecciosas, Hospital Mutua de Terrasa, Terrasa, Spain. [Rodríguez-Baño,J] Sección de Enfermedades Infecciosas, Hospital Universitario Virgen Macarena, Seville, Spain. [Rodríguez,F] Servicio de Microbiología Infecciosas, Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain.
Grupo de Investigación: The Spanish Network for Research in infectious Diseases (REIPI)
Palabras clave : Bacteriemia
Farmacorresistencia Bacteriana
Prevalencia
Pruebas de Sensibilidad Microbiana
Pseudomonas aeruginosa
España
MeSH: Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Bacteremia
Medical Subject Headings::Chemicals and Drugs::Organic Chemicals::Amides::Lactams::beta-Lactams::Carbapenems
Medical Subject Headings::Phenomena and Processes::Microbiological Phenomena::Bacterial Physiological Phenomena::Drug Resistance, Bacterial
Medical Subject Headings::Check Tags::Female
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Check Tags::Male
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Clinical Laboratory Techniques::Microbiological Techniques::Microbial Sensitivity Tests
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle Aged
Medical Subject Headings::Information Science::Information Science::Data Collection::Vital Statistics::Morbidity::Prevalence
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Negative Bacterial Infections::Pseudomonas Infections
Medical Subject Headings::Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Aerobic Bacteria::Gram-Negative Aerobic Rods and Cocci::Pseudomonadaceae::Pseudomonas::Pseudomonas aeruginosa
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Regression Analysis
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors
Medical Subject Headings::Geographicals::Geographic Locations::Europe::Spain
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Survival Analysis
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Aged
Fecha de publicación : Mar-2012
Editorial : American Society for Microbiology
Cita Bibliográfica: Peña C, Suarez C, Gozalo M, Murillas J, Almirante B, Pomar V, et al. Prospective multicenter study of the impact of carbapenem resistance on mortality in Pseudomonas aeruginosa bloodstream infections. Antimicrob Agents Chemother. 2012 ; 56(3):1265-72
Abstract: The impact of antimicrobial resistance on clinical outcomes is the subject of ongoing investigations, although uncertainty remains about its contribution to mortality. We investigated the impact of carbapenem resistance on mortality in Pseudomonas aeruginosa bacteremia in a prospective multicenter (10 teaching hospitals) observational study of patients with monomicrobial bacteremia followed up for 30 days after the onset of bacteremia. The adjusted influence of carbapenem resistance on mortality was studied by using Cox regression analysis. Of 632 episodes, 487 (77%) were caused by carbapenem-susceptible P. aeruginosa (CSPA) isolates, and 145 (23%) were caused by carbapenem-resistant P. aeruginosa (CRPA) isolates. The median incidence density of nosocomial CRPA bacteremia was 2.3 episodes per 100,000 patient-days (95% confidence interval [CI], 1.9 to 2.8). The regression demonstrated a time-dependent effect of carbapenem resistance on mortality as well as a significant interaction with the Charlson index: the deleterious effect of carbapenem resistance on mortality decreased with higher Charlson index scores. The impact of resistance on mortality was statistically significant only from the fifth day after the onset of the bacteremia, reaching its peak values at day 30 (adjusted hazard ratio for a Charlson score of 0 at day 30, 9.9 [95% CI, 3.3 to 29.4]; adjusted hazard ratio for a Charlson score of 5 at day 30, 2.6 [95% CI, 0.8 to 8]). This study clarifies the relationship between carbapenem resistance and mortality in patients with P. aeruginosa bacteremia. Although resistance was associated with a higher risk of mortality, the study suggested that this deleterious effect may not be as great during the first days of the bacteremia or in the presence of comorbidities.
Descripción : Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't;
URI: http://hdl.handle.net/10668/2004
Versión del editor : http://aac.asm.org/content/56/3/1265.abstract
DOI: 10.1128/AAC.05991-11
ISSN : 1098-6596 (Online)
0066-4804 (Print)
Appears in Collections:01- Artículos - Hospital Virgen del Rocío
01- Artículos - Hospital Virgen Macarena
01- Artículos - Hospital Reina Sofía
01- Artículos - IMIBIC. Instituto Maimónides de Investigación Biomédica de Córdoba

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