OBJECTIVE: To identify risk factors for infection or colonization with aztreonam-resistant Pseudomonas aeruginosa and examine the impact of this organism on mortality. DESIGN: A case-control study was performed to identify risk factors for infection or colonization with aztreonam-resistant P. aeruginosa. A cohort study was subsequently performed to examine the impact of aztreonam resistance on outcomes. SETTING: A tertiary referral center in southeastern Pennsylvania.Participants. Inpatients with a clinical culture positive for P. aeruginosa between January 1, 1999, and December 31, 2000. RESULTS: Of 720 P. aeruginosa. isolates, 183 (25.4%) were aztreonam-resistant and 537 (74.6%) were aztreonam susceptible. In a multivariable model, prior fluoroquinolone use (adjusted odds ratio [aOR], 1.81 [95% confidence interval {CI}, 1.17-2.80]), prior use of an antianaerobic agent (aOR, 1.56 [95% CI, 1.06-2.29]), and renal insufficiency (aOR, 1.59 [95% CI, 1.10-2.29]) were associated with infection or colonization with aztreonam-resistant P. aeruginosa, while older age (aOR, 0.98 [95% CI, 0.97-0.99] per year of age) was negatively associated with infection or colonization with this organism. In-hospital mortality was higher among subjects infected or colonized with aztreonam-resistant P. aeruginosa, compared with those who were infected or colonized with aztreonam-susceptible P. aeruginosa (25.7% vs 16.8%; P=.009), but in multivariable analysis, no significant association was found between infection or colonization with aztreonam-resistant P. aeruginosa and mortality. CONCLUSIONS: Curbing the use of fluoroquinolones and antimicrobials with antianaerobic activity may be an effective strategy to limit the emergence of aztreonam-resistant P. aeruginosa.
OBJECTIVE: To identify risk factors for infection or colonization with aztreonam-resistant Pseudomonas aeruginosa and examine the impact of this organism on mortality. DESIGN: A case-control study was performed to identify risk factors for infection or colonization with aztreonam-resistant P. aeruginosa. A cohort study was subsequently performed to examine the impact of aztreonam resistance on outcomes. SETTING: A tertiary referral center in southeastern Pennsylvania.Participants. Inpatients with a clinical culture positive for P. aeruginosa between January 1, 1999, and December 31, 2000. RESULTS: Of 720 P. aeruginosa. isolates, 183 (25.4%) were aztreonam-resistant and 537 (74.6%) were aztreonam susceptible. In a multivariable model, prior fluoroquinolone use (adjusted odds ratio [aOR], 1.81 [95% confidence interval {CI}, 1.17-2.80]), prior use of an antianaerobic agent (aOR, 1.56 [95% CI, 1.06-2.29]), and renal insufficiency (aOR, 1.59 [95% CI, 1.10-2.29]) were associated with infection or colonization with aztreonam-resistant P. aeruginosa, while older age (aOR, 0.98 [95% CI, 0.97-0.99] per year of age) was negatively associated with infection or colonization with this organism. In-hospital mortality was higher among subjects infected or colonized with aztreonam-resistant P. aeruginosa, compared with those who were infected or colonized with aztreonam-susceptible P. aeruginosa (25.7% vs 16.8%; P=.009), but in multivariable analysis, no significant association was found between infection or colonization with aztreonam-resistant P. aeruginosa and mortality. CONCLUSIONS: Curbing the use of fluoroquinolones and antimicrobials with antianaerobic activity may be an effective strategy to limit the emergence of aztreonam-resistant P. aeruginosa.
Authors: Lindsey P Koliscak; James W Johnson; James R Beardsley; David P Miller; John C Williamson; Vera P Luther; Christopher A Ohl Journal: Antimicrob Agents Chemother Date: 2013-09-16 Impact factor: 5.191
Authors: Leanne B Gasink; Paul H Edelstein; Ebbing Lautenbach; Marie Synnestvedt; Neil O Fishman Journal: Infect Control Hosp Epidemiol Date: 2009-12 Impact factor: 3.254
Authors: Nazaret Cobos-Trigueros; Mar Solé; Pedro Castro; Jorge Luis Torres; Cristina Hernández; Mariano Rinaudo; Sara Fernández; Álex Soriano; José María Nicolás; Josep Mensa; Jordi Vila; José Antonio Martínez Journal: Crit Care Date: 2015-05-04 Impact factor: 9.097