| Title |
The clinical significance of pneumonia in patients with respiratory specimens harbouring multidrug-resistant Pseudomonas aeruginosa: a 5-year retrospective study following 5667 patients in four general ICUs
|
|---|---|
| Published in |
European Journal of Clinical Microbiology & Infectious Diseases, June 2017
|
| DOI | 10.1007/s10096-017-3039-z |
| Pubmed ID | |
| Authors |
B. Borgatta, S. Gattarello, C. A. Mazo, A. T. Imbiscuso, M. N. Larrosa, M. Lujàn, J. Rello |
| Abstract |
Pseudomonas aeruginosa is the leading cause of pneumonia in intensive care units (ICUs), with multidrug-resistant (MDR) strains posing a serious threat. The aim of this study was to assess the clinical relevance of MDR Pseudomonas isolates in respiratory clinical specimens. A 5-year retrospective observational study in four medical-surgical ICUs from a referral hospital was carried out. Of 5667 adults admitted to the ICU, 69 had MDR-PA in respiratory samples: 31 were identified as having pneumonia (HAP/VAP): 21 ventilator-associated pneumonia (VAP) and ten hospital-acquired pneumonia (HAP). Twenty-one (67.7%) adults with MDR-PA HAP/VAP died after a median of 4 days (18 of the 21 deaths within 8 days), compared with one (2.6%) without pneumonia at day 8. In a Cox proportional regression model, MDR-PA pneumonia was an independent variable [adjusted hazard ratio (aHR) 5.92] associated with 30-day ICU mortality. Most strains (85.1%) were susceptible to amikacin and colistin. Resistance to beta-lactams (third-generation cephalosporins and piperacillin-tazobactam) ranged from 44.1% to 45.3%. Meropenem showed poor overall activity (MIC[50/90] 16/32 mg/dL), with 47.0% having a minimum inhibitory concentration (MIC) breakpoint >8 mg/L. Twenty-four (77.4%) HAP/VAP episodes received inappropriate empirical therapy. Although empirical combination therapy was associated with less inappropriate therapy than monotherapy (16.7% vs. 88.3%, p < 0.01), there was no difference in survival (30% vs. 33.3%, p = 0.8). Pneumonia was identified in one-third of adult ICU patients harbouring MDR-PA in respiratory clinical specimens. These patients have a 6-fold risk of (early) death compared to ventilator-associated tracheobronchitis (VAT) and respiratory colonisation. New antibiotics and adjuvant therapies are urgently needed to prevent and treat MDR-PA HAP/VAP. |
X Demographics
The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 2 | 67% |
| Unknown | 1 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 67% |
| Practitioners (doctors, other healthcare professionals) | 1 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 66 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 66 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 9 | 14% |
| Student > Ph. D. Student | 7 | 11% |
| Other | 6 | 9% |
| Student > Bachelor | 6 | 9% |
| Student > Master | 4 | 6% |
| Other | 8 | 12% |
| Unknown | 26 | 39% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 14 | 21% |
| Biochemistry, Genetics and Molecular Biology | 9 | 14% |
| Pharmacology, Toxicology and Pharmaceutical Science | 5 | 8% |
| Nursing and Health Professions | 3 | 5% |
| Immunology and Microbiology | 2 | 3% |
| Other | 5 | 8% |
| Unknown | 28 | 42% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 July 2017.
All research outputs
#15,465,171
of 22,981,247 outputs
Outputs from European Journal of Clinical Microbiology & Infectious Diseases
#1,889
of 2,791 outputs
Outputs of similar age
#198,939
of 316,926 outputs
Outputs of similar age from European Journal of Clinical Microbiology & Infectious Diseases
#30
of 58 outputs
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