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Prevalence of colis...
Prevalence of colistin heteroresistance in carbapenem-resistant Pseudomonas aeruginosa and association with clinical outcomes in patients : an observational study
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- Howard-Anderson, Jessica (författare)
- Emory Univ, Sch Med, Dept Med, Div Infect Dis, Atlanta, GA 30322 USA.;Georgia Emerging Infect Program, Decatur, GA 30033 USA.;Emory Antibiot Resistance Ctr, Atlanta, GA 30329 USA.
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- Davis, Michelle (författare)
- Emory Univ, Sch Med, Dept Med, Div Infect Dis, Atlanta, GA 30322 USA.;Georgia Emerging Infect Program, Decatur, GA 30033 USA.
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- Page, Alexander M. (författare)
- Emory Univ, Sch Med, Dept Med, Div Infect Dis, Atlanta, GA 30322 USA.;Georgia Emerging Infect Program, Decatur, GA 30033 USA.
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- Bower, Chris W. (författare)
- Georgia Emerging Infect Program, Decatur, GA 30033 USA.;Atlanta VA Med Ctr, Decatur, GA USA.;Fdn Atlanta Vet Educ & Res, Decatur, GA USA.
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- Smith, Gillian (författare)
- Georgia Emerging Infect Program, Decatur, GA 30033 USA.;Atlanta VA Med Ctr, Decatur, GA USA.;Fdn Atlanta Vet Educ & Res, Decatur, GA USA.
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- Jacob, Jesse T. (författare)
- Emory Univ, Sch Med, Dept Med, Div Infect Dis, Atlanta, GA 30322 USA.;Georgia Emerging Infect Program, Decatur, GA 30033 USA.;Emory Antibiot Resistance Ctr, Atlanta, GA 30329 USA.
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- Andersson, Dan I. (författare)
- Uppsala universitet,Institutionen för medicinsk biokemi och mikrobiologi
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- Weiss, David S. (författare)
- Emory Univ, Sch Med, Dept Med, Div Infect Dis, Atlanta, GA 30322 USA.;Emory Antibiot Resistance Ctr, Atlanta, GA 30329 USA.;Atlanta VA Med Ctr, Decatur, GA USA.
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- Satola, Sarah W. (författare)
- Emory Univ, Sch Med, Dept Med, Div Infect Dis, Atlanta, GA 30322 USA.;Georgia Emerging Infect Program, Decatur, GA 30033 USA.;Emory Antibiot Resistance Ctr, Atlanta, GA 30329 USA.;Atlanta VA Med Ctr, Decatur, GA USA.
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Emory Univ, Sch Med, Dept Med, Div Infect Dis, Atlanta, GA 30322 USA;Georgia Emerging Infect Program, Decatur, GA 30033 USA.;Emory Antibiot Resistance Ctr, Atlanta, GA 30329 USA. Emory Univ, Sch Med, Dept Med, Div Infect Dis, Atlanta, GA 30322 USA.;Georgia Emerging Infect Program, Decatur, GA 30033 USA. (creator_code:org_t)
- 2021-12-16
- 2022
- Engelska.
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Ingår i: Journal of Antimicrobial Chemotherapy. - : Oxford University Press (OUP). - 0305-7453 .- 1460-2091. ; 77:3, s. 793-798
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- Objectives: To describe the prevalence of colistin heteroresistance in carbapenem-resistant Pseudomonas aeruginosa (CRPA) and evaluate the association with clinical outcomes.Methods: Colistin heteroresistance was evaluated in CRPA isolates collected from patients without cystic fibrosis in Atlanta, Georgia, USA using two definitions: HR1, growth at 4 and 8 mg/L of colistin at a frequency >= 1 x 10(-6) the main population; and HR2, growth at a colistin concentration >= 8x the MIC of the main population at a frequency >= 1 x 10(-7). A modified population analysis profile (mPAP) technique was compared with reference PAP for detecting heteroresistance. For adults hospitalized at the time of or within 1 week of CRPA culture, multivariable logistic regression estimated the association between heteroresistance and 90 day mortality.Results: Of 143 colistin-susceptible CRPA isolates, 8 (6%) met the HR1 definition and 37 (26%) met the HR2 definition. Compared with the reference PAP, mPAP had a sensitivity and specificity of 50% and 100% for HR1 and 32% and 99% for HR2. Of 82 hospitalized patients, 45 (56%) were male and the median age was 63 years (IQR 49-73). Heteroresistance was not associated with 90 day mortality using HR1 (0% in heteroresistant versus 22% in non-heteroresistant group; P = 0.6) or HR2 (12% in heteroresistant versus 24% in non-heteroresistant group; P = 0.4; adjusted OR 0.8; 95% CI 0.2-3.4).Conclusions: Colistin heteroresistance was identified in up to 26% of patients with CRPA in our sample, although the prevalence varied depending on the definition. We did not observe an apparent association between colistin heteroresistance and 90 day mortality.
Ämnesord
- NATURVETENSKAP -- Biologi -- Biokemi och molekylärbiologi (hsv//swe)
- NATURAL SCIENCES -- Biological Sciences -- Biochemistry and Molecular Biology (hsv//eng)
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