Repositório Digital

A- A A+

Reappraisal of pseudomonas aeruginosa hospital-acquired pneumonia mortality in the era of metallo-B-lactamase-mediated multidrug resistance : a prospective observational study

.

Reappraisal of pseudomonas aeruginosa hospital-acquired pneumonia mortality in the era of metallo-B-lactamase-mediated multidrug resistance : a prospective observational study

Mostrar registro completo

Estatísticas

Título Reappraisal of pseudomonas aeruginosa hospital-acquired pneumonia mortality in the era of metallo-B-lactamase-mediated multidrug resistance : a prospective observational study
Autor Zavascki, Alexandre Prehn
Barth, Afonso Luis
Fernandes, Juliana Fernandez
Moro, Ana Lúcia Didonet
Gonçalves, Ana Lúcia Saraiva
Goldani, Luciano Zubaran
Abstract Introduction Hospital-acquired pneumonia (HAP) due to Pseudomonas aeruginosa is associated with high mortality rates. The metallo-β-lactamases (MBLs) are emerging enzymes that hydrolyze virtually all β-lactams. We aimed to assess P. aeruginosa HAP mortality in a setting of high-rate MBL production Methods A prospective cohort study was performed at two tertiary-care teaching hospitals. A logistic regression model was constructed to identify risk factors for 30-day mortality. Results One-hundred and fifty patients with P. aeruginosa HAP were evaluated. The 30-day mortality was 37.3% (56 of 150): 57.1% (24 of 42) and 29.6% (32 of 108) for patients with HAP by MBL-producing P. aeruginosa and by non-MBL-producing P. aeruginosa, respectively (relative risk, 1.93; 95% confidence interval (CI), 1.30–2.85). The logistic regression model identified a higher Charlson comorbidity score (odds ratio, 1.21; 95% CI, 1.04–1.41), presentation with severe sepsis or septic shock (odds ratio, 3.17; 95% CI, 1.30–7.72), ventilatorassociated pneumonia (odds ratio, 2.92; 95% CI, 1.18–7.21), and appropriate therapy (odds ratio, 0.24; 95% CI, 0.10–0.61) as independent factors for 30-day mortality. MBL production was not statistically significant in the final model. Conclusion MBL-producing P. aeruginosa HAP resulted in higher mortality rates, particularly in patients with ventilatorassociated pneumonia, most probably related to the less frequent institution of appropriate antimicrobial therapy. Therapeutic approaches should be reviewed at institutions with a high prevalence of MBL.
Contido em Critical care. Oxford. Vol. 10, n. 4 (2006), p. R114
Assunto Infecção hospitalar
Pneumonia
Pseudomonas aeruginosa
Origem Estrangeiro
Tipo Artigo de periódico
URI http://hdl.handle.net/10183/21535
Arquivos Descrição Formato
000584820.pdf (134.3Kb) Texto completo Adobe PDF Visualizar/abrir

Este item está licenciado na Creative Commons License

Este item aparece na(s) seguinte(s) coleção(ões)


Mostrar registro completo

Percorrer



  • O autor é titular dos direitos autorais dos documentos disponíveis neste repositório e é vedada, nos termos da lei, a comercialização de qualquer espécie sem sua autorização prévia.
    Projeto gráfico elaborado pelo Caixola - Clube de Criação Fabico/UFRGS Powered by DSpace software, Version 1.8.1.