BACKGROUND: A study was conducted in the Calgary Health Region between May 2002 and April 2004 to define the population-based epidemiological characteristics of infections caused by imipenem-resistant Pseudomonas aeruginosa and to explore the clinical outcomes due to metallo- beta -lactamase (MBL)-producing and non-MBL-producing strains. METHODS: Detailed clinical information was obtained by chart review, and phenotypic and molecular characterizations were performed using the MBL E-test, polymerase chain reaction with sequencing, and pulsed-field gel electrophoresis. RESULTS: A total of 228 patients with infections caused by imipenem-resistant P. aeruginosa were identified (annual incidence, 10.5 cases/100,000 population), with the highest incidence rate in those >or=75 years old. MBL-producing strains (98/228) were associated with higher rates of multidrug resistance and bacteremia. Ninety MBL-producing strains also produced VIM-2, 4 produced IMP-7, and 4 were unclassified. A cluster of VIM-2-producing strains was responsible for a nosocomial outbreak during 2003. The case-fatality rate was significantly higher for infections caused by MBL-producing strains than for those caused by non-MBL-producing strains (25% vs. 13%; relative risk, 1.98 [95% confidence interval, 1.00-3.90]; P=.05). CONCLUSION: MBL-producing P. aeruginosa strains were associated with a higher case-fatality rate and invasive disease. Our study highlights the potential importance of molecular laboratory techniques in infection control and patient care.
BACKGROUND: A study was conducted in the Calgary Health Region between May 2002 and April 2004 to define the population-based epidemiological characteristics of infections caused by imipenem-resistant Pseudomonas aeruginosa and to explore the clinical outcomes due to metallo- beta -lactamase (MBL)-producing and non-MBL-producing strains. METHODS: Detailed clinical information was obtained by chart review, and phenotypic and molecular characterizations were performed using the MBL E-test, polymerase chain reaction with sequencing, and pulsed-field gel electrophoresis. RESULTS: A total of 228 patients with infections caused by imipenem-resistant P. aeruginosa were identified (annual incidence, 10.5 cases/100,000 population), with the highest incidence rate in those >or=75 years old. MBL-producing strains (98/228) were associated with higher rates of multidrug resistance and bacteremia. Ninety MBL-producing strains also produced VIM-2, 4 produced IMP-7, and 4 were unclassified. A cluster of VIM-2-producing strains was responsible for a nosocomial outbreak during 2003. The case-fatality rate was significantly higher for infections caused by MBL-producing strains than for those caused by non-MBL-producing strains (25% vs. 13%; relative risk, 1.98 [95% confidence interval, 1.00-3.90]; P=.05). CONCLUSION: MBL-producing P. aeruginosa strains were associated with a higher case-fatality rate and invasive disease. Our study highlights the potential importance of molecular laboratory techniques in infection control and patient care.
Authors: U Garza-Ramos; R Morfin-Otero; H S Sader; R N Jones; E Hernández; E Rodriguez-Noriega; A Sanchez; B Carrillo; S Esparza-Ahumada; J Silva-Sanchez Journal: Antimicrob Agents Chemother Date: 2008-05-19 Impact factor: 5.191
Authors: G J German; M Gilmour; G Tipples; H J Adam; H Almohri; J Bullard; T Dingle; D Farrell; G Girouard; D Haldane; L Hoang; P N Levett; R Melano; J Minion; R Needle; S N Patel; R Rennie; R C Reyes; J Longtin; M R Mulvey Journal: Can Commun Dis Rep Date: 2018-01-04
Authors: G J German; F B Jamieson; M Gilmour; H Almohri; J Bullard; M C Domingo; J Fuller; G Girouard; D Haldane; L Hoang; P N Levett; J Longtin; R Melano; R Needle; S N Patel; A Rebbapragada; R C Reyes; M R Mulvey Journal: Can Commun Dis Rep Date: 2016-04-07
Authors: Orjan Samuelsen; Mark A Toleman; Arnfinn Sundsfjord; Johan Rydberg; Truls M Leegaard; Mats Walder; Astrid Lia; Trond E Ranheim; Yashas Rajendra; Nils O Hermansen; Timothy R Walsh; Christian G Giske Journal: Antimicrob Agents Chemother Date: 2009-11-02 Impact factor: 5.191