Impact of multidrug resistance on Pseudomonas aeruginosa ventilator-associated pneumonia outcome: predictors of early and crude mortality

The prevalence of multidrug-resistant (MDR) Pseudomonas aeruginosa has increased over the past decade and a significant rise in these isolates in ventilator-associated pneumonia (VAP) has been observed. However, the impact of MDR on VAP outcome has not been analysed in depth. We investigated the ris...

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Bibliographic Details
Published in:European journal of clinical microbiology & infectious diseases 2013-03, Vol.32 (3), p.413-420
Main Authors: Peña, C., Gómez-Zorrilla, S., Oriol, I., Tubau, F., Dominguez, M. A., Pujol, M., Ariza, J.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents - pharmacology
Anti-Bacterial Agents - therapeutic use
Antibiotics
Antimicrobial agents
Bacteremia
Biological and medical sciences
Biomedical and Life Sciences
Biomedicine
Disease
Drug resistance
Drug Resistance, Multiple, Bacterial
Female
General aspects
Human infectious diseases. Experimental studies and models
Humans
Illnesses
Infections
Infectious diseases
Internal Medicine
Intubation
Male
Medical Microbiology
Medical sciences
Middle Aged
Mortality
Multidrug resistance
Patients
Pneumology
Pneumonia
Pneumonia, Ventilator-Associated - epidemiology
Pneumonia, Ventilator-Associated - microbiology
Pneumonia, Ventilator-Associated - mortality
Pneumonia, Ventilator-Associated - pathology
Prognosis
Pseudomonas aeruginosa
Pseudomonas aeruginosa - drug effects
Pseudomonas aeruginosa - isolation & purification
Pseudomonas Infections - epidemiology
Pseudomonas Infections - microbiology
Pseudomonas Infections - mortality
Pseudomonas Infections - pathology
Regression analysis
Respiratory system : syndromes and miscellaneous diseases
Respiratory tract
Retrospective Studies
Risk Factors
Survival Analysis
Treatment Outcome
ventilator-associated pneumonia
Ventilators
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Description
Summary:The prevalence of multidrug-resistant (MDR) Pseudomonas aeruginosa has increased over the past decade and a significant rise in these isolates in ventilator-associated pneumonia (VAP) has been observed. However, the impact of MDR on VAP outcome has not been analysed in depth. We investigated the risk factors for early and crude mortality in a retrospective study of microbiologically and clinically documented VAP. Ninety-one VAP episodes in 83 patients were included, 31 caused by susceptible P . aeruginosa and 60 by MDR strains, of which 42 (70 %) were extensively drug-resistant (XDR) P . aeruginosa . Thirteen episodes concomitantly presented P . aeruginosa bacteraemia, in seven of which the origin was the respiratory tract. Whereas susceptible P . aeruginosa episodes were more likely than MDR episodes to receive adequate empirical (68 % vs. 30 %; p  
ISSN:0934-9723
1435-4373
DOI:10.1007/s10096-012-1758-8