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논문 기본 정보

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학술저널
저자정보
Kang Jin Suk (Division of Infectious Diseases Department of Internal Medicine Inje University Busan Paik Hospital) Moon Chisook (Division of Infectious Diseases Department of Internal Medicine Inje University Busan Paik Hospital) 문석준 (인제대학교) Lee Jeong Eun (Division of Infectious Diseases Department of Internal Medicine Pusan National University School of) Lee Soon Ok (Division of Infectious Diseases Department of Internal Medicine Pusan National University School of) Lee Shinwon (Division of Infectious Diseases Department of Internal Medicine Pusan National University School of) Lee Sun Hee (Division of Infectious Diseases Department of Internal Medicine Pusan National University School of)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.36 No.43
발행연도
2021.11
수록면
1 - 15 (15page)
DOI
10.3346/jkms.2021.36.e273

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Background: Infections caused by multidrug-resistant Pseudomonas aeruginosa (MDRPA) have been on the rise worldwide, and delayed active antimicrobial therapy is associated with high mortality. However, few studies have evaluated increases in P. aeruginosa infections with antimicrobial resistance and risk factors for such antimicrobial resistance in Korea. Here, we analyzed changes in antimicrobial susceptibility associated with P. aeruginosa bacteremia and identified risk factors of antimicrobial resistance. Methods: The medical records of patients with P. aeruginosa bacteremia who were admitted to a tertiary hospital between January 2009 and October 2020 were retrospectively reviewed. Antibiotic resistance rates were compared among the time periods of 2009?2012, 2013?2016, and 2017?2020 and between the intensive care unit (ICU) and non-ICU setting. Empirical antimicrobial therapy was considered concordant, if the organism was susceptible to antibiotics in vitro, and discordant, if resistant. Results: During the study period, 295 patients with P. aeruginosa bacteremia were identified. The hepatobiliary tract (26.8%) was the most common primary site of infection. The rates of carbapenem-resistant P. aeruginosa (CRPA), MDRPA, and extensively drug-resistant P. aeruginosa (XDRPA) were 24.7%, 35.9%, and 15.9%, respectively. XDRPA showed an increasing trend, and CRPA, MDRPA, and XDRPA were also gradually increasing in non-ICU setting. Previous exposure to fluoroquinolones and glycopeptides and urinary tract infection were independent risk factors associated with CRPA, MDRPA, and XDRPA. Previous exposure to carbapenems was an independent risk factor of CRPA. CRPA, MDRPA, and XDRPA were associated with discordant empirical antimicrobial therapy. Conclusion: The identification of risk factors for antimicrobial resistance and analysis of antimicrobial susceptibility might be important for concordant empirical antimicrobial therapy in patients with P. aeruginosa bacteremia.
#Pseudomonas aeruginosa #Bacteremia #Multidrug Resistance #Risk Factors

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참고문헌 (38)

참고문헌 신청
Parkins MD / 2010 / Population-based study of the epidemiology and the risk factors for Pseudomonas aeruginosa bloodstream infection / Infection 38(1):25~32 google schola Callejas-Díaz A / 2019 / Impact of Pseudomonas aeruginosa bacteraemia in a tertiary hospital: mortality and prognostic factors / Med Clin(Barc) 152(3):83~89 google schola Kang CI / 2003 / Pseudomonas aeruginosa bacteremia : risk factors for mortality and influence of delayed receipt of effective antimicrobial therapy on clinical outcome / Clin Infect Dis 37(6):745~751 google schola Suárez C / 2009 / Clinical impact of imipenemresistant Pseudomonas aeruginosa bloodstream infections / J Infect 58(4):285~290 google schola Buehrle DJ / 2016 / Carbapenem-resistant Pseudomonas aeruginosa bacteremia : risk factors for mortality and microbiologic treatment failure / Antimicrob Agents Chemother 61(1):e01243-16 google schola

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