RT Journal Article
T1 Prospective multicenter study of the impact of carbapenem resistance on mortality in Pseudomonas aeruginosa bloodstream infections.
A1 Peña, Carmen
A1 Suarez, Cristina
A1 Gozalo, Mónica
A1 Murillas, Javier
A1 Almirante, Benito
A1 Pomar, Virginia
A1 Aguilar, Manuela
A1 Granados, Ana
A1 Calbo, Esther
A1 Rodríguez-Baño, Jesús
A1 Rodríguez, Fernando
A1 Tubau, Fe
A1 Martínez-Martínez, Luis
A1 Oliver, Antonio
K1 Bacteriemia
K1 Farmacorresistencia Bacteriana
K1 Prevalencia
K1 Pruebas de Sensibilidad Microbiana
K1 Pseudomonas aeruginosa
K1 España
AB 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.
PB American Society for Microbiology
SN 0066-4804
YR 2012
FD 2012-03
LK http://hdl.handle.net/10668/2004
UL http://hdl.handle.net/10668/2004
LA en
NO 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
NO Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't;
DS RISalud
RD Apr 17, 2025