1. Rapid emergence of colistin resistance and its impact on fatality among healthcare-associated infections
- Author
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Pınar Ergen, Emel Yilmaz, Y. Tezer, H. Demirkaya, Yusuf Ziya Demiroglu, Cigdem Ataman Hatipoglu, Seniha Başaran, A. Tümtürk, Ilkay Karaoglan, Nazlim Aktug Demir, Mehtap Aydin, Özlem Kurt Azap, O. Memikoğlu, C. Karakoc, Suda Tekin, Halis Akalin, Hüseyin Bilgin, Alpay Azap, Onder Ergonul, Şebnem Erdinç, Gule Aydin, Onur Ural, Fusun Can, Şirin Menekşe, Ş.E. Çakar, Lutfiye Mulazimoglu, Şiran Keske, Şafak Kaya, Hikmet Eda Alışkan, S.A. Çavuş, C. Yardımcı, İstinye Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, and Karakoc, Zehra Cagla
- Subjects
0301 basic medicine ,Microbiology (medical) ,Adult ,Male ,medicine.medical_specialty ,Klebsiella pneumoniae ,030106 microbiology ,Bacteremia ,Bloodstream ,Microbial Sensitivity Tests ,medicine.disease_cause ,03 medical and health sciences ,0302 clinical medicine ,Colistin Mic ,Internal medicine ,Case fatality rate ,Gram-Negative Bacteria ,medicine ,Humans ,030212 general & internal medicine ,Aged ,Retrospective Studies ,Aged, 80 and over ,Cross Infection ,biology ,Gram-Negative ,Pseudomonas aeruginosa ,business.industry ,Colistin ,General Medicine ,Odds ratio ,Middle Aged ,biology.organism_classification ,Confidence interval ,Acinetobacter baumannii ,Anti-Bacterial Agents ,Health Care ,Infectious Diseases ,Carbapenems ,Female ,business ,Gram-Negative Bacterial Infections ,Enterobacter cloacae ,medicine.drug - Abstract
This article describes the emergence of resistance and predictors of fatality for 1556 cases of healthcare-associated Gram-negative bloodstream infection in 2014 and 2015. The colistin resistance rate in Klebsiella pneumoniae was 16.1%, compared with 6% in 2013. In total, 660 (42.4%) cases were fatal. The highest fatality rate was among patients with Acinetobacter baumannii bacteraemia (58%), followed by Pseudomonas aeruginosa (45%), Klebsiella pneumoniae (41%), Enterobacter cloacae (32%) and Escherichia coli (28%). On multi-variate analysis, the minimum inhibitory concentrations for carbapenems [odds ratio (OR) 1.02, 95% confidence interval (CI) 1.01-1.04; P = 0.002] and colistin (OR 1.1, 95% CI 1.03-1.17; P = 0.001) were found to be significantly associated with fatality. (C) 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved. WOS: 000426316700011 29248504 Q1
- Published
- 2017