Risk Factors and Outcomes of Antibiotic-resistant Pseudomonas aeruginosa Bloodstream Infection in Adult Patients With Acute Leukemia

Abstract Background Pseudomonas aeruginosa (PA) bloodstream infection (BSI) is a common complication in patients with acute leukemia (AL), and the prevalence of antibiotic-resistant strains poses a serious problem. However, there is limited information regarding antibiotic resistance, clinical characteristics, and outcomes of PA BSI in AL patients. This study explored characteristics associated with the clinical outcomes of AL patients with PA BSI and analyzed factors associated with BSI caused by multidrug-resistant (MDR) or carbapenem-resistant strains. Methods This single-center retrospective study enrolled hospitalized AL patients who developed PA BSI during January 2014–December 2019. The Kaplan-Meier method was used to plot survival curves. Multivariate logistic regression analyses were also performed. Results Of 293 eligible patients with PA BSI, 55 (18.8%) received inappropriate empirical antibiotic therapy within 48 hours of BSI onset, whereas up to 65.8% MDR-PA BSI patients received inappropriate empirical treatment. The 30-day mortality rate was 8.5% for all patients. However, the 30-day mortality rates were 28.9% and 5.5% in MDR-PA BSI and non–MDR-PA BSI patients, respectively (P < .001). On multivariate analysis, previous use of quinolones (odds ratio [OR], 5.851 [95% confidence interval {CI}, 2.638–12.975]) and piperacillin/tazobactam (OR, 2.837 [95% CI, 1.151–6.994]) were independently associated with MDR-PA BSI; and MDR-PA BSI (OR, 7.196 [95% CI, 2.773–18.668]), perianal infection (OR, 4.079 [95% CI, 1.401–11.879]), pulmonary infection (OR, 3.028 [95% CI, 1.231–7.446]), and age ≥55 years (OR, 2.871 [95% CI, 1.057–7.799]) were independent risk factors for 30-day mortality. Conclusions MDR increases mortality risk in PA BSI patients, and previous antibiotic exposure is important in MDR-PA BSI development. Rational antibiotic use based on local antimicrobial susceptibility and clinical characteristics can help reduce antibiotic resistance and mortality.

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A Extensively drug-resistant Pseudomonas putida bacteremia that was resolved spontaneously

The Journal of Infection in Developing Countries ◽

10.3855/jidc.11213 ◽

2019 ◽

Vol 13 (06) ◽

pp. 577-580

Author(s):

Hanife Usta Atmaca ◽

Feray Akbas

Keyword(s):

Risk Factors ◽

Pseudomonas Aeruginosa ◽

Antibiotic Resistance ◽

Pseudomonas Putida ◽

Invasive Procedure ◽

Clinical Information ◽

Drug Resistant ◽

Antibiotic Resistant ◽

Gastrointestinal Malignancy ◽

Extensively Drug Resistant

Pseudomonas putida (P. putida) is a rare pathogen that causes various infections in newborns, neutropenic and cancer patients, or in patients with risk factors leading to immunosuppresion. Antibiotic resistance in P. putida is seen in growing numbers. Although it is less virulent compared to Pseudomonas aeruginosa, mortal infections are reported. Here, a P. putida case after an invasive procedure in a patient with gastrointestinal malignancy is reported. Although, it caused an antibiotic resistant bacteremia, it resolved spontaneously without any treatment. P. Putida might have lower virulence and a different antibiotic susceptibility when compared to Pseudomonas aeruginosa in different cases. More clinical information is needed for further evaluation.

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Antibiotic resistance mechanisms of Vibrio cholerae

Journal of Medical Microbiology ◽

10.1099/jmm.0.023051-0 ◽

2011 ◽

Vol 60 (4) ◽

pp. 397-407 ◽

Cited By ~ 127

Author(s):

Maya Kitaoka ◽

Sarah T. Miyata ◽

Daniel Unterweger ◽

Stefan Pukatzki

Keyword(s):

Antibiotic Resistance ◽

Vibrio Cholerae ◽

Antibiotic Use ◽

Multidrug Resistant ◽

Resistance Mechanisms ◽

Alternative Methods ◽

Antibiotic Resistant ◽

Public Health Burden ◽

Initial Identification ◽

Resistant Strains

As the causative agent of cholera, the bacterium Vibrio cholerae represents an enormous public health burden, especially in developing countries around the world. Cholera is a self-limiting illness; however, antibiotics are commonly administered as part of the treatment regimen. Here we review the initial identification and subsequent evolution of antibiotic-resistant strains of V. cholerae. Antibiotic resistance mechanisms, including efflux pumps, spontaneous chromosomal mutation, conjugative plasmids, SXT elements and integrons, are also discussed. Numerous multidrug-resistant strains of V. cholerae have been isolated from both clinical and environmental settings, indicating that antibiotic use has to be restricted and alternative methods for treating cholera have to be implemented.

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Prevalence and risk factors for bloodstream infection present on hospital admission

Journal of Infection Prevention ◽

10.1177/1757177417720998 ◽

2017 ◽

Vol 19 (1) ◽

pp. 37-42 ◽

Cited By ~ 4

Author(s):

Sainfer Aliyu ◽

Bevin Cohen ◽

Jianfang Liu ◽

Elaine Larson

Keyword(s):

Risk Factors ◽

New York ◽

New York City ◽

Hospital Admission ◽

Bloodstream Infection ◽

Patient Outcomes ◽

Antibiotic Resistant ◽

Admission Source ◽

Resistant Strains ◽

Private Homes

Background: Bloodstream infection present on hospital admission (BSI-POA) is a major cause of morbidity and mortality. The purpose of this study was to measure prevalence and describe the risk factors of patients with BSI-POA and to determine the prevalence of resistance in isolates by admission source. Methods: We conducted a retrospective cohort study of patients discharged from three hospitals in New York City between 2006 and 2014. BSI-POA was defined as BSI diagnosed within 48 h of hospitalisation. Results: The prevalence for BSI-POA was 5307/315,010 discharges (1.7%). The odds of being admitted with BSI-POA were greatest among patients admitted with renal failure, chronic dermatitis, malignancies and prior hospitalisation. Odds ratios and 95% confidence intervals (CI) were 2.72 (95% CI = 2.56–2.88), 2.15 (95% CI = 1.97–2.34), 1.76 (95% CI = 1.64–1.88) and 1.59 (95% CI = 1.50–1.69), respectively. The largest proportion of BSI-POA presented with Staphylococcus aureus (48.4%), followed by Enterococcus faecalis/faecium (20.3%), Klebsiella pneumoniae (16.2%), Streptococcus pneumoniae (8.7%), Pseudomonas aeruginosa (4.2%) and Acinetobacter baumannii (2.2%). Overall, 44% of those admitted from nursing homes presented with antibiotic resistant strains versus 34% from other hospitals and 31% from private homes ( P = 0.002). Conclusion: Understanding the risk factors of patients who present to the hospital with BSI could enable timely interventions and better patient outcomes.

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Outpatient consumption of antibiotics is linked to antibiotic resistance in Europe: results from the European Surveillance of Antimicrobial Consumption

Weekly releases (1997–2007) ◽

10.2807/esw.10.08.02652-en ◽

2005 ◽

Vol 10 (8) ◽

Cited By ~ 1

Author(s):

A Johnson

Keyword(s):

European Union ◽

Antibiotic Resistance ◽

Antimicrobial Resistance ◽

Selective Pressure ◽

Antibiotic Use ◽

Antibiotic Consumption ◽

European Countries ◽

Antimicrobial Consumption ◽

Antibiotic Resistant ◽

Resistant Strains

There is increasing recognition that antibiotic consumption provides a major selective pressure for the emergence and persistence of antibiotic-resistant strains of bacteria. In 2001, a European Union Council Recommendation stated that data should be gathered on antibiotic use and antimicrobial resistance in European countries

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Microbiological and Molecular Genetic Aspects of Antibiotic Resistance of Pseudomonas aeruginosa and Acinetobacter baumannii

Epidemiology and Vaccinal Prevention ◽

10.31631/2073-3046-2019-18-6-34-38 ◽

2020 ◽

Vol 18 (6) ◽

pp. 34-38

Author(s):

Yu. E. Skurikhina ◽

V. B. Turkutyukov

Keyword(s):

Pseudomonas Aeruginosa ◽

Antibiotic Resistance ◽

Acinetobacter Baumannii ◽

Molecular Genetic ◽

Resistance Mechanisms ◽

Steady Increase ◽

Molecular Genetic Study ◽

Antibiotic Resistant ◽

Resistant Strains ◽

High Level

Relevance. The increase in the frequency of infections caused by Pseudomonas aeruginosa and Acinetobacter baumannii, which have a high level of resistance to many groups of antibiotics, requires a comprehensive study, including modern research methods.Aims. The study of regional features of the dynamics of the formation and circulation of antibiotic-resistant strains A. baumannii and P. aeruginosa.Materials and methods. During 2009-2018 we analyzed the data of microbiological laboratories of multidisciplinary hospitals and carried out a molecular genetic study of the determinants of antibiotic resistance by PCR of A. baumannii and P. aeruginosa strains isolated from clinical material in order to determine the level of variability of resistance.Results. The study revealed a tendency to increase in the proportion of strains A. baumannii and P. aeruginosa in the etiological structure of healh-care associated infections and purulent-septic infections; high incidence of strains resistant to cephalosporins, carbapenems, beta-lactams and multi-resistant strains. The appearance and distribution of the determinants of antibiotic resistance NDM-1 and MCR-1 in these bacteria were also detected.Conclusions. Over the past decade, a steady increase in the proportion of A. baumannii and P. Aeruginosa resistant to many antibiotics in patients in intensive care unit and surgery departments in hospitals of Vladivostok (Primorsky reg., Russia), and the emergence of new antimicrobial resistance mechanisms in these microorganisms.

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

Journal of Clinical Medicine ◽

10.3390/jcm10040758 ◽

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.

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Evidence of Another Anthropic Impact on Iguana delicatissima from the Lesser Antilles: The Presence of Antibiotic Resistant Enterobacteria

Antibiotics ◽

10.3390/antibiotics10080885 ◽

2021 ◽

Vol 10 (8) ◽

pp. 885

Author(s):

Gustavo Di Lallo ◽

Marco Maria D’Andrea ◽

Samanta Sennati ◽

Maria Cristina Thaller ◽

Luciana Migliore ◽

...

Keyword(s):

Antibiotic Resistance ◽

Animal Species ◽

Susceptibility Testing ◽

Acquired Resistance ◽

Climatic Conditions ◽

Antibiotic Resistant ◽

Associated Bacteria ◽

Improper Use ◽

Resistant Strains ◽

Drug Resistant Strains

The improper use of antibiotics by humans may promote the dissemination of resistance in wildlife. The persistence and spread of acquired antibiotic resistance and human-associated bacteria in the environment, while representing a threat to wildlife, can also be exploited as a tool to monitor the extent of human impact, particularly on endangered animal species. Hence, we investigated both the associated enterobacterial species and the presence of acquired resistance traits in the cloacal microbiota of the critically endangered lesser Antillean iguana (Iguana delicatissima), by comparing two separate populations living in similar climatic conditions but exposed to different anthropic pressures. A combination of techniques, including direct plating, DNA sequencing and antimicrobial susceptibility testing allowed us to characterize the dominant enterobacterial populations, the antibiotic resistant strains and their profiles. A higher frequency of Escherichia coli was found in the samples from the more anthropized site, where multi-drug resistant strains were also isolated. These results confirm how human-associated bacteria as well as their antibiotic-resistance determinants may be transferred to wildlife, which, in turn, may act as a reservoir of antibiotic resistance.

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Wastewater disinfection by solar heterogeneous photocatalysis: effect on tetracycline resistant/sensitive Enterococcus strains

Global NEST Journal ◽

10.30955/gnj.001331 ◽

2014 ◽

Vol 16 (3) ◽

pp. 455-462 ◽

Cited By ~ 7

Keyword(s):

Antibiotic Resistance ◽

Treatment Plant ◽

Heterogeneous Photocatalysis ◽

Resistance Pattern ◽

Urban Wastewater ◽

Antibiotic Resistant ◽

Disinfection Process ◽

Wastewater Disinfection ◽

Resistant Strains ◽

Urban Wastewater Treatment

<div> Solar simulated heterogeneous photocatalysis (SSHP) with suspended TiO2 was investigated in the inactivation of tetracycline resistant/sensitive Enterococcus (TRE/TSE) strains in the effluent of an urban wastewater treatment plant (UWTP). The effect of solar simulated disinfection (SSD) on the inactivation of the same Enterococcus strains was investigated as control. SSHP process (0.05 g l-1 of TiO2) was found to be effective in the inactivation of both Enterococcus strains with total inactivation (~7 log unit) observed after 60 min of irradiation. On the contrary, SSD process did not show any significant inactivation after 90 min of irradiation. The effect of both processes on the antibiotic resistance phenotypes of the surviving enterococci was also evaluated. TRE cells surviving the SSHP treatment showed that disinfection process did not affect the antibiotic resistance pattern after 45 min irradiation. The same was observed for the TSE strain. Accordingly, antibiotic resistance can spread into the receiving water body when antibiotic resistant strains survive to disinfection process. </div>

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Topical issues of inhaled antibacterial therapy of respiratory diseases in children

Medical Council ◽

10.21518/2079-701x-2018-17-128-131 ◽

2018 ◽

pp. 128-131 ◽

Cited By ~ 1

Author(s):

N. G. Kolosova ◽

A. B. Kolosova

Keyword(s):

Antibiotic Resistance ◽

Antibiotic Therapy ◽

Respiratory Diseases ◽

Respiratory Infections ◽

Infectious Agents ◽

Antibiotic Resistant ◽

Restriction Policy ◽

Resistant Strains ◽

Outpatient Practice ◽

Systemic Antibiotics

Despite the fact that acute respiratory infections have viral etiology, the frequency of antibiotic prescriptions accounts for more than 70% in outpatient practice. However, the preventive administration of systemic antibiotics does not reduce the duration of the disease and the incidence of bacterial complications. In addition, the irrational use of antibiotic therapy can lead to the development of antibiotic resistance of infectious disease pathogens. The global problem of antibiotic resistance is seen as a serious threat to public health, and therefore the systemic antibiotic restriction policy is crucial, which helps to reduce the formation of antibiotic-resistant strains of infectious agents. The possibility of using local antibacterial drugs enables optimization of antibiotic therapy and reduces the risk of the development of antibiotic resistance. The article discusses the issues of use of thiamphenicol glycinate acetylcysteinate in various diseases in children.

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The Future of Antibiotics and Meat

Impact of Meat Consumption on Health and Environmental Sustainability - Practice, Progress, and Proficiency in Sustainability ◽

10.4018/978-1-4666-9553-5.ch009 ◽

2016 ◽

pp. 178-200 ◽

Cited By ~ 4

Author(s):

Talia Raphaely ◽

Dora Marinova ◽

Mira Marinova

Keyword(s):

Antibiotic Resistance ◽

Food Chain ◽

Animal Husbandry ◽

Meat Consumption ◽

Antibiotic Use ◽

Meat Production ◽

Livestock Industry ◽

Antibiotic Resistant ◽

New Challenges ◽

Food Animals

This chapter discusses antibiotic use in the livestock industry and potential ramifications for human health. Antibiotics are routinely administered to food animals, primarily at sub-therapeutic levels. The extensive use of antibiotics in global animal husbandry in quantities greater than used for humans is creating antibiotic resistance. There is evidence that antibiotic resistant organisms emerging in food animals transfer to humans through the food chain, environmental contamination, direct association with animals or through mobile resistant genetic elements resulting in co-resistance to other antibiotics. No new classes of antibiotics have been developed since the 1980s. Intensifying use of existing antibiotics for meat production poses new challenges for treating humans, needs to be taken seriously and dealt with urgently. This chapter argues that reduced meat consumption is an under-considered but essential part in any suite of solutions aimed at preserving the use of antibiotics for human treatment.

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