Carbapenem-resistant Pseudomonas aeruginosa in Taiwan: Prevalence, risk factors, and impact on outcome of infections
Journal
Journal of Microbiology, Immunology and Infection
Journal Volume
49
Journal Issue
1
Pages
52-59
Date Issued
2016
Author(s)
Abstract
Background: The prevalence and clinical impact on mortality of carbapenem-resistant Pseudomonas aeruginosa (CRPA) is unclear in Taiwan. We aim to clarify these clinical issues by using data from the Taiwan Surveillance of Antimicrobial Resistance (TSAR) program. Methods: Patients from five hospitals with their P. aeruginosa isolates collected by TSAR II-VII (2000-2010) program were considered as the potential study population. All patients with CRPA were enrolled as case patients. Patients with carbapenem-susceptible P. aeruginosa were randomly selected in a 1:1 ratio to case patients as control patients. CRPA isolates were tested for the presence of carbapenemase-producing genes. The clinical data were collected to identify risk factors for CRPA carriage and mortality of P. aeruginosa infection. Results: The overall prevalence of CRPA was 10.2% (349/3408), which increased significantly by the TSAR period (= 0.007). Among the 164 enrolled patients, the risk factor for carrying CRPA was previous fluoroquinolone exposure (= 0.004). The risk factors for mortality among 80 patients with infection by P. aeruginosa included: intensive care unit (ICU) setting, receipt of antifungal therapy, and presence of invasive devices (= 0.001, 0.010, and 0.017; respectively). Carbapenem resistance did not play a role. Among the 82 CRPA isolates enrolled in this study, 15 isolates were found to carry carbapenemase-producing genes. Conclusion: In Taiwan, the prevalence of CRPA and carriage of carbapenemase-producing genes was high. However, carbapenem resistance did not play a role in the mortality of patients with P. aeruginosa infections. ? 2014.
SDGs
Other Subjects
amikacin; carbapenem; colistin; imipenem; levofloxacin; piperacillin plus tazobactam; antiinfective agent; carbapenem derivative; aged; antibiotic sensitivity; antibiotic therapy; Article; bacterial colonization; bacterial phenomena and functions; bacterial prevalence; carbapenem resistant Pseudomonas aeruginosa; comorbidity; controlled study; female; human; immunosuppressive treatment; infection risk; major clinical study; male; mortality; multicenter study; nonhuman; outcome assessment; predictive value; prevalence; Pseudomonas aeruginosa; Pseudomonas infection; sex ratio; Taiwan; adult; antibiotic resistance; drug effects; heterozygote; hospital; isolation and purification; microbiology; middle aged; prevalence; Pseudomonas aeruginosa; Pseudomonas Infections; risk factor; survival analysis; treatment outcome; very elderly; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; beta-Lactam Resistance; Carbapenems; Carrier State; Female; Hospitals; Humans; Male; Middle Aged; Prevalence; Pseudomonas aeruginosa; Pseudomonas Infections; Risk Factors; Survival Analysis; Taiwan; Treatment Outcome
Publisher
Elsevier Ltd
Type
journal article