Health and economic outcomes of antibiotic resistance in Pseudomonas aeruginosa
Health and economic outcomes of antibiotic resistance in Pseudomonas aeruginosa
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DOI：
10.1001/archinte.159.10.1127
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发表时间：
1999-05-24
影响因子：
--
通讯作者：
Samore, MH
中科院分区：
文献类型：
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作者：
Carmeli, Y;Troillet, N;Samore, MH
背景资料：抗菌药物耐药性是一个日益严重的问题。目的：探讨铜绿假单胞菌抗生素耐药性的临床和经济影响。方法：在医院死亡率，继发菌血症，住院时间和住院费用进行了研究，在一个队列的489例铜绿假单胞菌临床培养阳性的住院患者。144例基线耐药铜绿假单胞菌分离株，30例在随访期间出现耐药。结果：总的住院死亡率为7.6%，基线时耐药菌株患者为7.7（相对危险度[RR]，1.3; 95%置信区间[CI]，0.6-2.8），耐药患者中为27%（RR，3.0; 95% CI，1.2-7.8）。未出现耐药的患者中有1.4%发生继发性菌血症，出现耐药的患者中有14%发生继发性菌血症（RR，9.0; 95%CI，2.7-30）。初始铜绿假单胞菌分离后的中位住院时间为7天。耐药的出现，而不是基线耐药，与较长的住院时间显著相关（P
Background: Antimicrobial resistance is an increasing problem.Objective: To examine the clinical and economic impact of antibiotic resistance in Pseudomonas aeruginosa.Methods: In-hospital mortality, secondary bacteremia, length of stay, and hospital charges were examined in a cohort of 489 inpatients with positive clinical cultures for P aeruginosa. One hundred forty-four had a resistant baseline P aeruginosa isolate and 30 had resistance emerge during follow-up. Multivariable and survival analytic methods were used to adjust for confounding and effects of time.Results: The overall in-hospital mortality rate was 7.6%, 7.7% in patients with a resistant isolate at baseline (relative risk [RR], 1.3; 95% confidence interval [CI], 0.6-2.8) and 27% in patients in whom resistance emerged (RR, 3.0; 95% CI, 1.2-7.8). Secondary bacteremia developed in 1.4% of patients in whom resistance did not emerge and in 14% of those in whom resistance emerged (RR, 9.0; 95% CI, 2.7-30). The median duration of hospital stay following the initial P aeruginosa isolate was 7 days. Emergence of resistance, but not baseline resistance, was significantly associated with a longer hospital stay (P