scholarly journals Risk factors for pan-resistant Pseudomonas aeruginosa bacteremia and the adequacy of antibiotic therapy

2012 ◽  
Vol 16 (4) ◽  
pp. 351-356 ◽  
Author(s):  
Felipe F. Tuon ◽  
Lucas W. Gortz ◽  
Jaime L. Rocha
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Antibiotic Therapy

scholarly journals Risk Factors for Acquisition of Fluoroquinolone or Aminoglycoside Resistance in Addition to Carbapenem Resistance in Pseudomonas aeruginosa

2017 ◽  
Vol 11 (1) ◽  
pp. 92-97 ◽  
Author(s):  
Kosuke Kosai ◽  
Norihito Kaku ◽  
Naoki Uno ◽  
Tomomi Saijo ◽  
Yoshitomo Morinaga ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Antibiotic Therapy ◽  
Multivariate Analyses ◽  
Common Factor ◽  
Carbapenem Resistance ◽  
Appropriate Use ◽  
Aminoglycoside Resistance ◽  
Microbiological Characteristics ◽  
Resistant Strains

Background: Carbapenems, fluoroquinolones (FQs), and aminoglycosides (AGs) are key drugs for treating Pseudomonas aeruginosa infections, and accumulation of drug resistances make antibiotic therapy difficult. Methods: We evaluated 169 patients with imipenem (IPM)-resistant P. aeruginosa and compared patient background and microbiological characteristics between groups with or without FQ resistance. Similar analyses were performed for AG. Results: Of the 169 IPM-resistant strains, 39.1% showed resistance to FQs and 7.1% to AGs. The frequency of exposure to FQs within 90 days previously was higher in the group with FQ resistance (45.5%) than in the group without FQ resistance (13.6%). Similarly, 33.3% of patients in the group with AG resistance had been previously administered AGs, higher than the 7.6% of patients without AG resistance. Frequencies of metallo-β-lactamase (MBL) production were higher in the group with FQ or AG resistance (16.7% or 33.3%) than in the group without FQ or AG resistance (2.9% or 6.4%). Multivariate analyses showed exposures to FQs or AGs were related to the respective resistances. MBL production was a common factor for resistance to FQs or AGs, in addition to IPM-resistant P. aeruginosa. Conclusion: As well as promoting appropriate use of antibiotics, MBL production should be detected as a target of intervention for infection control.

scholarly journals Risk Factors for Mortality among Patients with Pseudomonas aeruginosa Bloodstream Infections: What Is the Influence of XDR Phenotype on Outcomes?

2020 ◽  
Vol 9 (2) ◽  
pp. 514
Author(s):  
María Milagro Montero ◽  
Inmaculada López Montesinos ◽  
Hernando Knobel ◽  
Ema Molas ◽  
Luisa Sorlí ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
High Risk ◽  
Antibiotic Therapy ◽  
Antimicrobial Therapy ◽  
Protective Factor ◽  
Bloodstream Infections ◽  
Clinical Severity ◽  
Risk Source ◽  
The Impact

This study aimed to assess the impact of extensively drug-resistant (XDR) phenotype on mortality in Pseudomonas aeruginosa bacteremia. A retrospective cohort study was performed in a tertiary hospital from January 2000 to December 2018. All consecutive prospectively recorded P. aeruginosa bacteremia in adult patients were assessed. In this study, 382 patients were included, of which 122 (31.9%) due to XDR P. aeruginosa. Independent factors associated with 14-day mortality were as follows: high-risk source of bacteremia (hazard ratio (HR) 3.07, 95% confidence interval (CI), 1.73–5.46), septic shock (HR 1.75, 95% CI, 1.12–2.75), and higher Pitt scores (one-point increments; HR 1.25, 95% CI, 1.12–1.38). Otherwise, the appropriateness of definitive antibiotic therapy was a protective factor (HR 0.39, 95% CI, 0.24–0.62). The same variables were also associated with 30-day mortality. XDR phenotype was not associated with 14- or 30-day mortality. In a subanalysis considering only high-risk source cases, combined antimicrobial therapy was independently associated with 14-day favorable outcome (HR 0.56, 95% CI, 0.33–0.93). In conclusion, XDR phenotype was not associated with poor prognosis in patients with P. aeruginosa bacteremia in our cohort. However, source of infection, clinical severity, and inappropriate definitive antibiotic therapy were risk factors for mortality. Combined antimicrobial therapy should be considered for high-risk sources.

scholarly journals Colour Me Blue: The History and the Biotechnological Potential of Pyocyanin

Molecules ◽  
2021 ◽  
Vol 26 (4) ◽  
pp. 927
Author(s):  
Thiago Gonçalves ◽  
Ulrich Vasconcelos
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antibiotic Therapy ◽  
Electric Current ◽  
Antimicrobial Therapy ◽  
Blue Colour ◽  
Current Generation ◽  
Biotechnological Potential ◽  
Avant Garde ◽  
New Horizons ◽  
The Subject

Pyocyanin was the first natural phenazine described. The molecule is synthesized by about 95% of the strains of Pseudomonas aeruginosa. From discovery up to now, pyocyanin has been characterised by a very rich and avant-garde history, which includes its use in antimicrobial therapy, even before the discovery of penicillin opened the era of antibiotic therapy, as well as its use in electric current generation. Exhibiting an exuberant blue colour and being easy to obtain, this pigment is the subject of the present review, aiming to narrate its history as well as to unveil its mechanisms and suggest new horizons for applications in different areas of engineering, biology and biotechnology.

scholarly journals Staphylococcus aureus Keratitis: Incidence, Pathophysiology, Risk Factors and Novel Strategies for Treatment

2021 ◽  
Vol 10 (4) ◽  
pp. 758
Author(s):  
Jason W. Lee ◽  
Tobi Somerville ◽  
Stephen B. Kaye ◽  
Vito Romano
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Clinical Characteristics ◽  
Surgical Intervention ◽  
Current Evidence ◽  
Bacterial Keratitis ◽  
Novel Therapies ◽  
Causative Pathogen ◽  
Novel Treatments

Bacterial keratitis is a devastating condition that can rapidly progress to serious complications if not treated promptly. Certain causative microorganisms such as Staphylococcus aureus and Pseudomonas aeruginosa are notorious for their resistance to antibiotics. Resistant bacterial keratitis results in poorer outcomes such as scarring and the need for surgical intervention. Thorough understanding of the causative pathogen and its virulence factors is vital for the discovery of novel treatments to avoid further antibiotic resistance. While much has been previously reported on P. aeruginosa, S. aureus has been less extensively studied. This review aims to give a brief overview of S. aureus epidemiology, pathophysiology and clinical characteristics as well as summarise the current evidence for potential novel therapies.

scholarly journals Risk Factors for diarrhea associated with Clostridium difficile in patients at a clinical hospital

2019 ◽  
Vol 91 (11) ◽  
pp. 20-25
Author(s):  
Y N Yarushina ◽  
G B Kolotova ◽  
V A Rudnov ◽  
V A Bagin
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Clostridium Difficile ◽  
Antibiotic Therapy ◽  
Case Histories ◽  
Clinical Hospital ◽  
Comorbidity Index ◽  
Autonomous Institution ◽  
Therapeutic Profile

Aim: to identify risk factors for Clostridium difficile infection in patients of a therapeutic clinic in a multidisciplinary hospital. Materials and methods. A retrospective analysis of 110 case histories of patients who were hospitalized in therapeutic departments in the Municipal Autonomous Institution “City Clinical Hospital No. 40” in Yekaterinburg (MAU City Clinical Hospital No. 40) in 2014-2015 was conducted, in which antibiotic therapy has developed diarrhea. According to the results of the study of coprofiltrate on Clostridium difficile (CD), patients were divided into 2 groups: 60 patients with a positive result and 50 patients with a negative result. Results. The proportion of patients with CD infection in the structure of patients of the therapeutic profile of the MAU GKB No.40 for 2014-2015 amounted to 0.42%. Predictors of the risk of developing diarrhea associated with CD infection in patients are: age over 65 years (OS 4.33, 95% CI 1.15-16.20, p=0.028), Charlson comorbidity index more than 2 points (OS 3.05, 95% CI 1.29-7.23, p=0.016), the presence of anemia (OR 2.32, 95% CI 1.07-5.02, p=0.048), chronic dialysis in patients with chronic renal insufficiency (CRF) (OR 8.64, 95% CI 1.05-70.81, p=0.020), patients staying in hospital for more than 5 days (OR 3.50, 95% CI 1.57-7.75, p=0.003) and hospitalization of patients in the intensive care unit (ICU) lasting more than 1 day (OS 9.80, 95% CI 1.20-79.47, p=0.011), the use of proton pump inhibitors (PPIs) (OR 2.82, 95% CI 1.12-7.11, p=0.041), antibiotic therapy more than 10 days (OS 39.62, 95% CI 10.85-144.71, p

scholarly journals Risk Factors of Catheter-Related Infection in Patients Undergoing Hemodialysis Using Double Lumen Catheter at Dr. M. Djamil Hospital Padang

2021 ◽  
Vol 6 (1) ◽  
pp. 1292-1299
Author(s):  
Muhammad Iqbal ◽  
Raflis Rustam ◽  
Vendry Rivaldy
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Clinical Manifestations ◽  
Bloodstream Infections ◽  
Sampling Technique ◽  
Exit Site ◽  
Double Lumen ◽  
Exit Site Infection ◽  
Double Lumen Catheter ◽  
Lumen Catheter

Background. Chronic kidney disease (CKD) is a terminal disease requiring hemodialysis. Hemodialysis requires vascular access using a double lumen catheter (DLC). However, the use of DLC may increase complications mainly infection, either infection of exit site or bloodstream. This study is aimed to seek risk factors contributing to the incidence of central catheter-related infections in CKD patients with DLC undergoing HD at Dr. M. Djamil Hospital, Padang. Methods. This study is a prospective study on patients undergoing HD at Dr. M. Djamil Hospital, Padang. This study using consecutive sampling technique. Data were analyzed using SPSS version 25.0. Results. This study involved 40 CKD patients undergoing HD. Majority of the samples had bloodstream infections (67.5%). Clinical manifestations of purulent secretion, duration of catheter used, and hypoalbuminemia had significant differences in the incidence of DLC infection based on bloodstream infection and exit site infection (p<0.05). The most common bacterial found was Pseudomonas aeruginosa (22.5%) which was sensitive to ceftazidime, cefepime, meropenem, amikacin, gentamicin, ciprofloxacin. Conclusion. Factors contributing to the incidence of DLC-related infections at Dr. M. Djamil Hospital are duration of catheter use and hypoalbuminemia. Pseudomonas aeruginosa is the most common cause of DLC-related infections.

scholarly journals Local audit of empiric antibiotic therapy in bacteremia: A retrospective cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248817
Author(s):  
Anthony D. Bai ◽  
Neal Irfan ◽  
Cheryl Main ◽  
Philippe El-Helou ◽  
Dominik Mertz
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Blood Culture ◽  
Antibiotic Therapy ◽  
Retrospective Cohort Study ◽  
Clinical Pathway ◽  
Retrospective Cohort ◽  
Negative Likelihood Ratio ◽  
Empiric Antibiotic Therapy ◽  
Empiric Antibiotic

Background It is unclear if a local audit would be useful in providing guidance on how to improve local practice of empiric antibiotic therapy. We performed an audit of antibiotic therapy in bacteremia to evaluate the proportion and risk factors for inadequate empiric antibiotic coverage. Methods This retrospective cohort study included patients with positive blood cultures across 3 hospitals in Hamilton, Ontario, Canada during October of 2019. Antibiotic therapy was considered empiric if it was administered within 24 hours after blood culture collection. Adequate coverage was defined as when the isolate from blood culture was tested to be susceptible to the empiric antibiotic. A multivariable logistic regression model was used to predict inadequate empiric coverage. Diagnostic accuracy of a clinical pathway based on patient risk factors was compared to clinician’s decision in predicting which bacteria to empirically cover. Results Of 201 bacteremia cases, empiric coverage was inadequate in 56 (27.9%) cases. Risk factors for inadequate empiric coverage included unknown source at initiation of antibiotic therapy (adjusted odds ratio (aOR) of 2.76 95% CI 1.27–6.01, P = 0.010) and prior antibiotic therapy within 90 days (aOR of 2.46 95% CI 1.30–4.74, P = 0.006). A clinical pathway that considered community-associated infection as low risk for Pseudomonas was better at ruling out Pseudomonas bacteremia with a negative likelihood ratio of 0.17 (95% CI 0.03–1.10) compared to clinician’s decision with negative likelihood ratio of 0.34 (95% CI 0.10–1.22). Conclusions An audit of antibiotic therapy in bacteremia is feasible and may provide useful feedback on how to locally improve empiric antibiotic therapy.

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