Risk factors and the resistance mechanisms involved in Pseudomonas aeruginosa mutation in critically ill patients

Journal of Intensive Care
Stéphanie DrugeBernard Georges

Abstract

The objective of this study was to determine the main risk factors of Pseudomonas aeruginosa mutation as well as the mechanisms of acquired resistance. We conducted a 2-year prospective study in patients who were carriers of a Pseudomonas aeruginosa strain and who had been admitted to a medical/surgical ICU. Of the 153 patients who were included, 34 had a mutation in their strain. In a multivariate analysis, a duration of ventilation > 24 days was a risk factor for mutation (risk ratio 4.29; CI 95% 1.94-9.49) while initial resistance was a protective factor (RR 0.36; CI 95% 0.18-0.71). In a univariate analysis, exposure of P. aeruginosa to ceftazidime was associated with an over-production of AmpC cephalosporinase and exposure to meropenem was associated with impermeability. A segmentation method based on the duration of ventilation (> 24 days), initial resistance, and exposure of strains to ceftazidime made it possible to predict at 83% the occurrence of mutation. The duration of ventilation and the presence of resistance as soon as P. aeruginosa is identified are predictive factors of mutation in ICU patients.

References

Dec 27, 2005·Antimicrobial Agents and Chemotherapy·Valerie AloushYehuda Carmeli
Jun 6, 2006·The American Journal of Medicine·Leanne B GasinkEbbing Lautenbach
Jun 9, 2009·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·L VettorettiX Bertrand
Jul 14, 2009·Journal of Critical Care·Guilherme H C FurtadoEduardo A S Medeiros
Jun 30, 2010·Antimicrobial Agents and Chemotherapy·Vincent H TamKevin W Garey
Jun 15, 2011·Trends in Microbiology·Elena B M BreidensteinRobert E W Hancock
Jan 29, 2013·Critical Care Medicine·R Phillip DellingerUNKNOWN Surviving Sepsis Campaign Guidelines Committee including the Pediatric Subgroup
Feb 2, 2013·Intensive Care Medicine·Mario TumbarelloMassimo Antonelli
Apr 13, 2013·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Carmen PeñaUNKNOWN Spanish Network for Research in Infectious Diseases (REIPI)
Apr 17, 2013·The Journal of Antimicrobial Chemotherapy·Damien FournierKaty Jeannot
May 28, 2014·Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi·Heng-Sim LeeChishih Chu
Aug 27, 2014·The Journal of Hospital Infection·A-G VenierUNKNOWN DYNAPYO study group
Sep 28, 2014·Journal of Medical Microbiology·Raquel Cavalcanti DantasRosineide Marques Ribas
Feb 3, 2015·Seminars in Respiratory and Critical Care Medicine·Kate McCarthy
Apr 11, 2015·International Journal of Antimicrobial Agents·Anaïs PotronPatrice Nordmann
May 6, 2015·Critical Care : the Official Journal of the Critical Care Forum·Nazaret Cobos-TriguerosJosé Antonio Martínez
Jun 17, 2015·Intensive Care Medicine·Cédric BretonnièreUNKNOWN Société Française d’Anesthésie et de Réanimation (SFAR)
Jul 15, 2015·Infection & chemotherapy·Duck Jin HongKyungwon Lee
Nov 20, 2016·Diagnostic Microbiology and Infectious Disease·Young Kyung YoonUNKNOWN Antibiotic Stewardship Study Group
Nov 21, 2016·The Journal of Infection·Laia Fernández-BaratAntoni Torres

❮ Previous
Next ❯

Citations


❮ Previous
Next ❯

Methods Mentioned

BETA
bronchoalveolar lavages

Software Mentioned

SPSS Statistics
MedCalc®

Related Concepts

Related Feeds

Carbapenems (ASM)

Carbapenems are members of the beta lactam class of antibiotics and are used for the treatment of severe or high-risk bacterial infections. Discover the latest research on carbapenems here.

Carbapenems

Carbapenems are members of the beta lactam class of antibiotics and are used for the treatment of severe or high-risk bacterial infections. Discover the latest research on carbapenems here.

Related Papers

DICP : the Annals of Pharmacotherapy
M BalaguéJ M Arnau
European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
J MasseS Nseir
Critical Care Medicine
Wendy LimPROphylaxis for ThromboEmbolism in Critical Care Trial Investigators
© 2021 Meta ULC. All rights reserved