Risk factors for hospital-acquired pneumonia caused by carbapenem-resistant Gram-negative bacteria in critically ill patients: a multicenter study in Korea

2014 ◽  
Vol 78 (4) ◽  
pp. 457-461 ◽  
Author(s):  
Tark Kim ◽  
Yong Pil Chong ◽  
Seong Yeon Park ◽  
Min-Hyok Jeon ◽  
Eun Joo Choo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Critically Ill ◽  
Multicenter Study ◽  
Critically Ill Patients ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Carbapenem Resistant ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

scholarly journals Inhalation with intravenous loading dose of colistin in critically ill patients with pneumonia caused by carbapenem-resistant gram-negative bacteria

2019 ◽  
Vol 13 ◽  
pp. 175346661988552 ◽  
Author(s):  
Junsu Choe ◽  
You Min Sohn ◽  
Suk Hyeon Jeong ◽  
Hyo Jung Park ◽  
Soo Jin Na ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Gram Negative Bacteria ◽  
Loading Dose ◽  
Gram Negative ◽  
Carbapenem Resistant ◽  
Optimal Dosing ◽  
Microbiological Outcome ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

Background: Despite the increasing use of colistin in clinical practice, the optimal dosing, and administration route have not been established. This study aimed to evaluate the clinical outcome and safety of intravenous (IV) colistin with a loading dose (LD) and adjunctive aerosolized (AS) colistin administration in critically ill patients with hospital-acquired pneumonia (HAP) or ventilator-associated pneumonia (VAP) caused by carbapenem-resistant gram-negative bacteria (CRGNB). Methods: We retrospectively reviewed 191 critically ill patients who received colistin for the treatment of HAP or VAP caused by CRGNB. Patients were divided into three groups: non-LD IV (patients received only IV colistin without LD), LD IV (patients received only IV colistin with LD), and AS–LD (patients received IV colistin with LD and adjunctive AS colistin). Results: There was no difference in clinical response between the three groups. However, the rate of microbiological eradication was significantly higher in the AS–LD group (60%) than in the non-LD IV (31%), and LD IV (33%) groups ( p = 0.010). Patients treated with adjunctive AS colistin in combination with LD IV had significantly lower 30-day mortality rates than patients treated with IV colistin alone ( p = 0.027). After adjusting for potential confounding factors, adjunctive AS colistin was still significantly associated with lower mortality (adjusted OR 0.338, CI 95% 0.132–0.864, p = 0.024). However, nephrotoxicity did not change according to the use of LD regimen and AS colistin administration ( p = 0.100). Conclusions: Adjunctive AS colistin in combination with IV colistin with LD was related to an improved 30-day mortality and microbiological outcome without an increase in nephrotoxicity in critically ill patients with HAP and VAP caused by CRGNB. The reviews of this paper are available via the supplemental material section.

scholarly journals Clinical characteristics and risk factors for the isolation of multi-drug-resistant Gram-negative bacteria from critically ill patients with COVID-19

2021 ◽  
Vol 110 ◽  
pp. 165-171
Author(s):  
A. Baiou ◽  
A.A. Elbuzidi ◽  
D. Bakdach ◽  
A. Zaqout ◽  
K.M. Alarbi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Clinical Characteristics ◽  
Gram Negative Bacteria ◽  
Drug Resistant ◽  
Gram Negative

scholarly journals Risk factors for bronchial acquisition of resistant Gram-negative bacteria in critically ill patients and outcome

Critical Care ◽  
2012 ◽  
Vol 16 (S1) ◽  
Author(s):  
I Papakonstantinou ◽  
E Perivolioti ◽  
C Vrettou ◽  
I Baraboutis ◽  
E Magira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Gram Negative Bacteria ◽  
Gram Negative

scholarly journals Population Pharmacokinetic Analysis of Colistin Methanesulfonate and Colistin after Intravenous Administration in Critically Ill Patients with Infections Caused by Gram-Negative Bacteria

2009 ◽  
Vol 53 (8) ◽  
pp. 3430-3436 ◽  
Author(s):  
D. Plachouras ◽  
M. Karvanen ◽  
L. E. Friberg ◽  
E. Papadomichelakis ◽  
A. Antoniadou ◽  
...  
Keyword(s):  
Steady State ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Compartment Model ◽  
Population Pharmacokinetic Analysis ◽  
Pharmacokinetic Analysis ◽  
Population Pharmacokinetic ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Colistin Methanesulfonate

ABSTRACT Colistin is used to treat infections caused by multidrug-resistant gram-negative bacteria (MDR-GNB). It is administered intravenously in the form of colistin methanesulfonate (CMS), which is hydrolyzed in vivo to the active drug. However, pharmacokinetic data are limited. The aim of the present study was to characterize the pharmacokinetics of CMS and colistin in a population of critically ill patients. Patients receiving colistin for the treatment of infections caused by MDR-GNB were enrolled in the study; however, patients receiving a renal replacement therapy were excluded. CMS was administered at a dose of 3 million units (240 mg) every 8 h. Venous blood was collected immediately before and at multiple occasions after the first and the fourth infusions. Plasma CMS and colistin concentrations were determined by a novel liquid chromatography-tandem mass spectrometry method after a rapid precipitation step that avoids the significant degradation of CMS and colistin. Population pharmacokinetic analysis was performed with the NONMEM program. Eighteen patients (6 females; mean age, 63.6 years; mean creatinine clearance, 82.3 ml/min) were included in the study. For CMS, a two-compartment model best described the pharmacokinetics, and the half-lives of the two phases were estimated to be 0.046 h and 2.3 h, respectively. The clearance of CMS was 13.7 liters/h. For colistin, a one-compartment model was sufficient to describe the data, and the estimated half-life was 14.4 h. The predicted maximum concentrations of drug in plasma were 0.60 mg/liter and 2.3 mg/liter for the first dose and at steady state, respectively. Colistin displayed a half-life that was significantly long in relation to the dosing interval. The implications of these findings are that the plasma colistin concentrations are insufficient before steady state and raise the question of whether the administration of a loading dose would benefit critically ill patients.

scholarly journals Colonization and infection by colistin-resistant Gram-negative bacteria in a cohort of critically ill patients

2011 ◽  
Vol 17 (11) ◽  
pp. E9-E11 ◽  
Author(s):  
F. Kontopidou ◽  
D. Plachouras ◽  
E. Papadomichelakis ◽  
G. Koukos ◽  
I. Galani ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Gram Negative Bacteria ◽  
Gram Negative

scholarly journals Factors influencing mortality in hospital-acquired pneumonia caused by Gram-negative bacteria in China

2019 ◽  
Vol 12 (5) ◽  
pp. 630-633 ◽  
Author(s):  
Ding-Yun Feng ◽  
Yu-Qi Zhou ◽  
Xiao-Ling Zou ◽  
Mi Zhou ◽  
Wen-Bin Wu ◽  
...  
Keyword(s):  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Factors Influencing ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

Risk factors and prognosis of catheter-related bloodstream infection in critically ill patients: a multicenter study

2008 ◽  
Vol 34 (12) ◽  
pp. 2185-2193 ◽  
Author(s):  
Jose Garnacho-Montero ◽  
Teresa Aldabó-Pallás ◽  
Mercedes Palomar-Martínez ◽  
Jordi Vallés ◽  
Benito Almirante ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bloodstream Infection ◽  
Critically Ill ◽  
Multicenter Study ◽  
Critically Ill Patients ◽  
Catheter Related Bloodstream Infection

scholarly journals Tigecycline Therapy for Nosocomial Pneumonia due to Carbapenem-Resistant Gram-Negative Bacteria in Critically Ill Patients Who Received Inappropriate Initial Antibiotic Treatment: A Retrospective Case Study

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Xiaomai Wu ◽  
Yefei Zhu ◽  
Qiuying Chen ◽  
Liuyang Gong ◽  
Jian Lin ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Critically Ill ◽  
Nosocomial Pneumonia ◽  
Critically Ill Patients ◽  
Standard Dose ◽  
High Dose ◽  
Gram Negative Bacteria ◽  
Loading Dose ◽  
Icu Mortality ◽  
Carbapenem Resistant

Background. Nosocomial pneumonia due to carbapenem-resistant Gram-negative bacteria (CRGNB) is a growing concern because treatment options are limited and the mortality rate is high. The effect of tigecycline (TGC) on nosocomial pneumonia due to CRGNB in patients who have received inappropriate initial empiric antibiotic treatment (IIAT) is unclear. Therefore, this study aimed to examine the effect of TGC on nosocomial pneumonia due to CRGNB in critically ill patients who had received IIAT. Methods. A retrospective study was conducted in an adult respiratory intensive care unit. Data were obtained and analyzed for all patients who were treated with TGC ≥ 3 days for microbiologically confirmed nosocomial pneumonia due to CRGNB and had experienced initial antibiotic failure. Clinical and microbiological outcomes were investigated. Results. Thirty-one patients with hospital-acquired pneumonia or ventilator-associated pneumonia were included in the study. The majority of the responsible organisms were carbapenem-resistant Acinetobacter baumannii (67.7%), followed by Klebsiella pneumoniae (16.1%) and Escherichia coli (9.7%). Twenty patients were treated with high-dose TGC therapy (100 mg every 12 h after a 200 mg loading dose), and the others received a standard-dose therapy (50 mg every 12 h after a 100 mg loading dose). The duration of TGC therapy was 14.3±2.8 days. The global clinical cure rate and the microbiological eradication rate were 48.4% and 61.3%, respectively. The overall ICU mortality rate was 45.2%. A higher score on the Acute Physiology and Chronic Health Evaluation II and a longer duration of IIAT were associated with clinical failure. High-dose TGC therapy had a higher clinical success rate [65.0% (13/20) versus 18.2% (2/11), P=0.023] and a lower ICU mortality rate [30.0% (6/20) versus 72.7% (8/11), P=0.031] than the standard-dose therapy. Conclusions. TGC, especially a high-dose regimen, might be a justifiable option for critically ill patients with nosocomial pneumonia due to CRGNB who have received IIAT when the options for these patients are limited.

Risk factors for infection/colonization caused by resistant Gram negative bacilli in critically ill patients (An observational study of 1633 critically ill patients)

2013 ◽  
Vol 57 ◽  
pp. S70-S73 ◽  
Author(s):  
Anupama Vasudevan ◽  
Amartya Mukhopadhyay ◽  
Eugene Yu-Yuen Goh ◽  
Jialiang Li ◽  
Paul Ananth Tambyah
Keyword(s):  
Risk Factors ◽  
Observational Study ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Gram Negative
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