Rapid emergence of colistin resistance and its impact on fatality among healthcare-associated infections.

Date
2018
Author
Menekse, S.
Aydin, M.
Ergonul, O.
Azap, A.
Bilgin, H.
Aydin, G.
Cavus, S. A.
Demiroglu, Y. Z.
Aliskan, H. E.
Memikoglu, O.
Kaya, S.
Demir, N. A.
Karaoglan, I.
Tezer, Y.
Demirkaya, H.
Cakar, S. E.
Keske, S.
Tekin, S.
Yardimci, C.
Karakoc, C.
Basaran, Seniha
Ergen, P.
Azap, O.
Mulazimoglu, L.
Ural, O.
Can, F.
Akalin, H.
Yilmaz, E.
Hatipoglu, C.
Erdinc, S.
Tumturk, A.
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Abstract
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. (C) 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
URI
http://hdl.handle.net/20.500.12627/114485
https://doi.org/10.1016/j.jhin.2017.11.014
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