Pseudomonas aeruginosa bacteremia over a 10-year period: multidrug resistance and outcomes in transplant recipients

Johnson, L.E., D'Agata, E.M.C., Paterson, D.L., Clarke, L., Qureshi, ZA, Potoski, BA and Peleg, AY (2009) Pseudomonas aeruginosa bacteremia over a 10-year period: multidrug resistance and outcomes in transplant recipients. Transplant Infectious Disease, 11 3: 227-234. doi:10.1111/j.1399-3062.2009.00380.x


Author Johnson, L.E.
D'Agata, E.M.C.
Paterson, D.L.
Clarke, L.
Qureshi, ZA
Potoski, BA
Peleg, AY
Title Pseudomonas aeruginosa bacteremia over a 10-year period: multidrug resistance and outcomes in transplant recipients
Journal name Transplant Infectious Disease   Check publisher's open access policy
ISSN 1398-2273
Publication date 2009-06-01
Year available 2009
Sub-type Article (original research)
DOI 10.1111/j.1399-3062.2009.00380.x
Open Access Status
Volume 11
Issue 3
Start page 227
End page 234
Total pages 8
Editor Aruna Subramanian
Petra Reinke
Place of publication Copenhagan, Denmark
Publisher Wiley-Blackwell Munksgaard
Language eng
Subject C1
920109 Infectious Diseases
110309 Infectious Diseases
Abstract AIM: Transplant recipients are at risk for hospital-acquired infections (HAIs), including those caused by Pseudomonas aeruginosa. Of all HAIs, bloodstream infection (BSI) remains one of the most life-threatening. METHODS: Over a 10-year period, we studied 503 patients, including 149 transplant recipients, with pseudomonal BSI from the University of Pittsburgh Medical Center. Trends in antimicrobial susceptibility, risk factors for multidrug resistance (MDR), and outcomes were compared between transplant and non-transplant patients. RESULTS: Resistance to all antibiotic classes was significantly greater in pseudomonal blood culture isolates from transplant compared with non-transplant patients (P<0.001). Of isolates from transplant recipients (n=207), 43% were MDR, compared with 18% of isolates from non-transplant patients (n=391) (odds ratio [OR] 3.47; 95% confidence interval [CI] 2.34-5.14, P<0.001). Among all patients, independent risk factors for MDR P. aeruginosa BSI included previous transplantation (OR 2.38; 95% CI 1.51-3.76, P<0.001), hospital-acquired BSI (OR 2.41; 95% CI 1.39-4.18, P=0.002), and prior intensive care unit (ICU) admission (OR 2.04; 95% CI 1.15-3.63, P=0.015). Mortality among transplant recipients was 42%, compared with 32% in non-transplant patients (OR 1.55; 95% CI 0.87-2.76, P=0.108). For transplant recipients, onset of BSI in the ICU was the only independent predictor of mortality (OR 8.00; 95% CI 1.71-37.42, P=0.008). CONCLUSIONS: Transplant recipients are at greater risk of MDR P. aeruginosa BSI, with an appreciable mortality. Future management must concentrate on the implementation of effective preventative strategies.
Keyword Pseudomonas aeruginosa
bloodstream infection
Resistance
Transplantation
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
2010 Higher Education Research Data Collection
 
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Created: Thu, 03 Sep 2009, 18:01:15 EST by Mr Andrew Martlew on behalf of UQ Centre for Clinical Research