Rapid emergence of colistin resistance and its impact on fatality among healthcare-associated infections. Issue 3 (March 2018)

• Record Type: Journal Article
• Authors: Aydın, M.; Ergönül, Ö.; Azap, A.; Bilgin, H.; Aydın, G.; Çavuş, S.A.; Demiroğlu, Y.Z.; Alışkan, H.E.; Memikoğlu, O.; Menekşe, Ş.; Kaya, Ş.; Demir, N.A.; Karaoğlan, İ.; Başaran, S.; Hatipoğlu, Ç.; Erdinç, Ş.; Yılmaz, E.; Tümtürk, A.; Tezer, Y.; Demirkaya, H.; Çakar, Ş.E.; Keske, Ş.; Tekin, S.; Yardımcı, C.; Karakoç, Ç.; Ergen, P.; Azap, Ö.; Mülazımoğlu, L.; Ural, O.; Can, F.; Akalın, H.;
• Is Part Of: Journal of hospital infection. Volume 98:Issue 3(2018)
• Page Start: 260
• Page End: 263
• Publication Date: 2018-03
• Subjects: Bloodstream -- Gram-negative -- Health care -- Colistin MIC; Cross infection -- Periodicals; Cross infection -- Prevention -- Periodicals; Nosocomial infections -- Periodicals; Nosocomial infections -- Prevention -- Periodicals; Cross Infection -- Periodicals; Cross Infection -- prevention & control -- Periodicals; Infection Control -- Periodicals; Electronic journals; 614.44
• DOI: 10.1016/j.jhin.2017.11.014
• Languages: English
• ISSNs: 0195-6701

Abstract

Summary: This article describes the emergence of resistance and predictors of fatality for 1556 cases of healthcare-associated Gram-negative bloodstream infection in 2014 and 2015. The colistin resistance rate in Klebsiella pneumoniae was 16.1%, compared with 6% in 2013. In total, 660 (42.4%) cases were fatal. The highest fatality rate was among patients with Acinetobacter baumannii bacteraemia (58%), followed by Pseudomonas aeruginosa (45%), Klebsiella pneumoniae (41%), Enterobacter cloacae (32%) and Escherichia coli (28%). On multi-variate analysis, the minimum inhibitory concentrations for carbapenems [odds ratio (OR) 1.02, 95% confidence interval (CI) 1.01–1.04; P = 0.002] and colistin (OR 1.1, 95% CI 1.03–1.17; P = 0.001) were found to be significantly associated with fatality.