Risk factors for mortality in patients with bloodstream infections caused by carbapenem-resistant Pseudomonas aeruginosa: clinical impact of bacterial virulence and strains on outcome

被引:38
作者
Jeong, Su Jin [1 ,2 ]
Yoon, Sang Sun [3 ]
Bae, Il Kwon [4 ]
Jeong, Seok Hoon [5 ]
Kim, June Myung [1 ,2 ,6 ]
Lee, Kyungwon
机构
[1] Yonsei Univ, Coll Med, Dept Internal Med, Seoul, South Korea
[2] Yonsei Univ, Coll Med, AIDS Res Inst, Seoul, South Korea
[3] Yonsei Univ, Coll Med, Dept Microbiol & Immunol, Seoul, South Korea
[4] Silla Univ, Dept Dent Hyg, Pusan, South Korea
[5] Yonsei Univ, Coll Med, Dept Lab Med, Seoul, South Korea
[6] Yonsei Univ, Coll Med, Res Inst Bacterial Resistance, Seoul, South Korea
关键词
Pseudomonas aeruginosa bloodstream infection; Carbapenem-resistant Pseudomonas aeruginosa; Mortality; Virulence factors; ANTIMICROBIAL RESISTANCE; NOSOCOMIAL INFECTIONS; BETA-LACTAMASES; DISSEMINATION; DEFINITIONS; BACTEREMIA; MECHANISMS; SEVERITY;
D O I
10.1016/j.diagmicrobio.2014.07.003
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
The incidence of carbapenem-resistant Pseudomonas aeruginosa (CRPA) bacteremia has increased in recent years, and infections caused by CRPA result in higher mortality than those caused by susceptible strains. This study was performed to evaluate the risk factors for mortality and to study the impact of virulence factors and bacterial strains on clinical outcomes in patients with CRPA bacteremia. Data on 63 episodes of CRPA bacteremia that have occurred between January 1, 2007, and December 31, 2009, in a teaching hospital (2000 beds) in Seoul, Korea, were analyzed. The Acute Physiology and Chronic Health Evaluation II (APACHE II) score at the time of CRPA bacteremia and the capacity of CRPA to form biofilm were independent predictive factors for mortality in patients with CRPA bacteremia. In addition, the biofilm-forming ability and elastase activity of strains were correlated with APACHE II scores to measure the severity of disease and estimate predicted mortality in the patients. (C) 2014 Elsevier Inc. All rights reserved.
引用
收藏
页码:130 / 135
页数:6
相关论文
共 34 条
[2]  
[Anonymous], AM J MED
[3]  
[Anonymous], INT J ANTIMICROB AGE
[4]   Nosocomial bacteremia caused by antibiotic-resistant gram-negative bacteria in critically ill patients: Clinical outcome and length of hospitalization [J].
Blot, S ;
Vandewoude, K ;
De Bacquer, D ;
Colardyn, F .
CLINICAL INFECTIOUS DISEASES, 2002, 34 (12) :1600-1606
[5]   DEFINITIONS FOR SEPSIS AND ORGAN FAILURE AND GUIDELINES FOR THE USE OF INNOVATIVE THERAPIES IN SEPSIS [J].
BONE, RC ;
BALK, RA ;
CERRA, FB ;
DELLINGER, RP ;
FEIN, AM ;
KNAUS, WA ;
SCHEIN, RMH ;
SIBBALD, WJ .
CHEST, 1992, 101 (06) :1644-1655
[6]   Pseudomonas aeruginosa protease IV enzyme assays and comparison to other pseudomonas proteases [J].
Caballero, AR ;
Moreau, JM ;
Engel, LS ;
Marquart, ME ;
Hill, JM ;
O'Callaghan, RJ .
ANALYTICAL BIOCHEMISTRY, 2001, 290 (02) :330-337
[7]   A NEW METHOD OF CLASSIFYING PROGNOSTIC CO-MORBIDITY IN LONGITUDINAL-STUDIES - DEVELOPMENT AND VALIDATION [J].
CHARLSON, ME ;
POMPEI, P ;
ALES, KL ;
MACKENZIE, CR .
JOURNAL OF CHRONIC DISEASES, 1987, 40 (05) :373-383
[8]  
CLSI, 2012, PERF STAND ANT SUS S
[9]   Bacterial biofilms: A common cause of persistent infections [J].
Costerton, JW ;
Stewart, PS ;
Greenberg, EP .
SCIENCE, 1999, 284 (5418) :1318-1322
[10]   Development of a multilocus sequence typing scheme for the opportunistic pathogen Pseudomonas aeruginosa [J].
Curran, B ;
Jonas, D ;
Grundmann, H ;
Pitt, T ;
Dowson, CG .
JOURNAL OF CLINICAL MICROBIOLOGY, 2004, 42 (12) :5644-5649