Attributable mortality of antibiotic resistance in gram-negative infections in the Netherlands: a parallel matched cohort study

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
Wouter C RottierMarc J M Bonten

Abstract

Antibiotic resistance in Gram-negative bacteria has been associated with increased mortality. This was demonstrated mostly for third-generation cephalosporin-resistant (3GC-R) Enterobacterales bacteraemia in international studies. Yet, the burden of resistance specifically in the Netherlands and created by all types of Gram-negative infection has not been quantified. We therefore investigated the attributable mortality of antibiotic resistance in Gram-negative infections in the Netherlands. In eight hospitals, a sample of Gram-negative infections was identified between 2013 and 2016, and separated into resistant and susceptible infection cohorts. Both cohorts were matched 1:1 to non-infected control patients on hospital, length of stay at infection onset, and age. In this parallel matched cohort set-up, 30-day mortality was compared between infected and non-infected patients. The impact of resistance was then assessed by dividing the two separate risk ratios (RRs) for mortality attributable to Gram-negative infection. We identified 1954 Gram-negative infections, of which 1190 (61%) involved Escherichia coli, 210 (11%) Pseudomonas aeruginosa, and 758 (39%) bacteraemia. Resistant Gram-negatives caused 243 infections (12%; 189 (78...Continue Reading

References

Oct 9, 2012·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·M E A de KrakerH Grundmann
Dec 12, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·H S M AmmerlaanM J M Bonten
Jul 23, 2013·Euro Surveillance : Bulletin Européen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin·C GlasnerUNKNOWN European Survey on Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) Working Group
Nov 19, 2015·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·J M FitzpatrickUNKNOWN United Kingdom Clinical Infection Research Group
Dec 27, 2015·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·N D FriedmanY Carmeli
Jul 19, 2016·Future Microbiology·Jan-Willem H DikAlexander W Friedrich
Aug 27, 2016·Euro Surveillance : Bulletin Européen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin·Andrew J StewardsonUNKNOWN TIMBER Study Group
Sep 23, 2018·JAMA : the Journal of the American Medical Association·Michael KlompasMervyn Singer

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