Extensively Drug-Resistant Pseudomonas aeruginosa Bacteremia in Solid Organ Transplant Recipients
BACKGROUNDWe sought to determine the risk factors, molecular epidemiology, antibiotic therapy, and outcomes of bacteremia because of extensively drug-resistant (XDR) Pseudomonas aeruginosa in solid organ transplant (SOT) recipients. METHODSAll episodes of bacteremia occurring in SOT recipients were prospectively documented from 2007 to 2013. RESULTSOf 318 episodes of bacteremia, 49 were caused by P. aeruginosa. Thirty-one strains (63%) were XDR defined by nonsusceptibility to at least one agent in all but two or fewer antipseudomonal antimicrobial categories. Time from transplantation to bacteremia was shorter in XDR P. aeruginosa group comparing to other etiologies (median days 66 vs. 278; P=0.03). Factors independently associated with XDR P. aeruginosa bacteremia were prior transplantation, nosocomial acquisition, and septic shock at onset. XDR P. aeruginosa isolates belonged to a single clone (ST-175). Comparing to other etiologies, patients with bacteremia because of XDR P. aeruginosa more often received inadequate empirical antibiotic therapy. Persistence of bacteremia, shock, respiratory failure and intensive care unit admission were more frequent in patients with XDR P. aeruginosa. The overall case-fatality rate was higher among patients with XDR P. aeruginosa bacteremia than in the others (38% vs. 16%; P=0.009). CONCLUSIONBacteremia because of XDR P. aeruginosa should be carefully considered when selecting empirical antibiotic therapy for hospitalized SOT recipients with prior transplantation presenting with septic shock..
Medienart: |
Artikel |
---|
Erscheinungsjahr: |
2015 |
---|---|
Erschienen: |
2015 |
Enthalten in: |
Zur Gesamtaufnahme - volume:99 |
---|---|
Enthalten in: |
Transplantation - 99(2015), 3, Seite 616-622 |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Bodro, Marta [VerfasserIn] |
---|
Links: |
---|
BKL: | |
---|---|
Themen: |
Anti-Bacterial Agents - therapeutic use |
RVK: |
---|
doi: |
10.1097/TP.0000000000000366 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
OLC1964462576 |
---|
LEADER | 01000caa a2200265 4500 | ||
---|---|---|---|
001 | OLC1964462576 | ||
003 | DE-627 | ||
005 | 20220222134556.0 | ||
007 | tu | ||
008 | 160206s2015 xx ||||| 00| ||eng c | ||
024 | 7 | |a 10.1097/TP.0000000000000366 |2 doi | |
028 | 5 | 2 | |a PQ20160617 |
035 | |a (DE-627)OLC1964462576 | ||
035 | |a (DE-599)GBVOLC1964462576 | ||
035 | |a (PRQ)c2276-b7d168838e76edc0a42e5ec1091fb0267d70d407ee04c6cbac150b7965cc4200 | ||
035 | |a (KEY)0031140520150000099000300616extensivelydrugresistantpseudomonasaeruginosabacte | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
082 | 0 | 4 | |a 610 |q DNB |
084 | |a XA 10000 |q AVZ |2 rvk | ||
084 | |a 44.65 |2 bkl | ||
100 | 1 | |a Bodro, Marta |e verfasserin |4 aut | |
245 | 1 | 0 | |a Extensively Drug-Resistant Pseudomonas aeruginosa Bacteremia in Solid Organ Transplant Recipients |
264 | 1 | |c 2015 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
338 | |a Band |b nc |2 rdacarrier | ||
520 | |a BACKGROUNDWe sought to determine the risk factors, molecular epidemiology, antibiotic therapy, and outcomes of bacteremia because of extensively drug-resistant (XDR) Pseudomonas aeruginosa in solid organ transplant (SOT) recipients. METHODSAll episodes of bacteremia occurring in SOT recipients were prospectively documented from 2007 to 2013. RESULTSOf 318 episodes of bacteremia, 49 were caused by P. aeruginosa. Thirty-one strains (63%) were XDR defined by nonsusceptibility to at least one agent in all but two or fewer antipseudomonal antimicrobial categories. Time from transplantation to bacteremia was shorter in XDR P. aeruginosa group comparing to other etiologies (median days 66 vs. 278; P=0.03). Factors independently associated with XDR P. aeruginosa bacteremia were prior transplantation, nosocomial acquisition, and septic shock at onset. XDR P. aeruginosa isolates belonged to a single clone (ST-175). Comparing to other etiologies, patients with bacteremia because of XDR P. aeruginosa more often received inadequate empirical antibiotic therapy. Persistence of bacteremia, shock, respiratory failure and intensive care unit admission were more frequent in patients with XDR P. aeruginosa. The overall case-fatality rate was higher among patients with XDR P. aeruginosa bacteremia than in the others (38% vs. 16%; P=0.009). CONCLUSIONBacteremia because of XDR P. aeruginosa should be carefully considered when selecting empirical antibiotic therapy for hospitalized SOT recipients with prior transplantation presenting with septic shock. | ||
540 | |a Nutzungsrecht: Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. | ||
650 | 4 | |a Anti-Bacterial Agents - therapeutic use | |
650 | 4 | |a Bacteremia - pathology | |
650 | 4 | |a Pseudomonas aeruginosa - drug effects | |
700 | 1 | |a Sabé, Núria |4 oth | |
700 | 1 | |a Tubau, Fe |4 oth | |
700 | 1 | |a Lladó, Laura |4 oth | |
700 | 1 | |a Baliellas, Carme |4 oth | |
700 | 1 | |a González-Costello, José |4 oth | |
700 | 1 | |a Cruzado, Josep Maria |4 oth | |
700 | 1 | |a Carratalà, Jordi |4 oth | |
773 | 0 | 8 | |i Enthalten in |t Transplantation |d Hagerstown, Md. : Lippincott Williams & Wilkins, 1963 |g 99(2015), 3, Seite 616-622 |w (DE-627)129501905 |w (DE-600)208424-7 |w (DE-576)014903555 |x 0041-1337 |7 nnns |
773 | 1 | 8 | |g volume:99 |g year:2015 |g number:3 |g pages:616-622 |
856 | 4 | 1 | |u http://dx.doi.org/10.1097/TP.0000000000000366 |3 Volltext |
856 | 4 | 2 | |u http://www.ncbi.nlm.nih.gov/pubmed/25119130 |
912 | |a GBV_USEFLAG_A | ||
912 | |a SYSFLAG_A | ||
912 | |a GBV_OLC | ||
912 | |a GBV_ILN_4012 | ||
912 | |a GBV_ILN_4219 | ||
936 | r | v | |a XA 10000 |
936 | b | k | |a 44.65 |q AVZ |
951 | |a AR | ||
952 | |d 99 |j 2015 |e 3 |h 616-622 |