Emergence of antibiotic-resistant Pseudomonas aeruginosa:: Comparison of risks associated with different antipseudomonal agents
Emergence of antibiotic-resistant Pseudomonas aeruginosa:: Comparison of risks associated with different antipseudomonal agents
复制标题
DOI：
10.1128/aac.43.6.1379
复制
发表时间：
1999-06-01
影响因子：
4.9
通讯作者：
Samore, MH
中科院分区：
文献类型：
--
作者：
Carmeli, Y;Troillet, N;Samore, MH
铜绿假单胞菌是医院感染的主要原因。抗生素耐药性的风险随着不同的抗生素治疗而不同。为了比较环丙沙星、头孢他啶、亚胺培南和哌拉西林四种抗假单胞菌药物相关的耐药性出现的风险，我们进行了一项队列研究，评估了接受任何这些药物治疗的患者中出现耐药铜绿假单胞菌的相对风险。共271例铜绿假单胞菌感染患者（随访3，810天）接受了研究药物治疗。耐药28例（10.2%）。调整后的耐药风险比如下：头孢他啶，0.7（P = 0.4）;环丙沙星0.8亚胺培南2.8（P = 0.02）;哌拉西林，1.7（P = 0.3），与使用相同药剂治疗相关的对每种单独药剂的耐药性出现的风险比如下：头孢他啶0.8（P = 0.7），环丙沙星9.2（P = 0.04），亚胺培南44（P = 0.001），哌拉西林5.2（P = 0.01）。我们的结论是，有明显的差异，抗生素的可能性，他们的使用模具允许铜绿假单胞菌耐药性的出现。头孢他啶与最低风险相关，亚胺培南风险最高。
Pseudomonas aeruginosa is a leading cause of nosocomial infections. The risk of emergence of antibiotic resistance mag vary with different antibiotic treatments. To compare the risks of emergence of resistance associated with four antipseudomonal agents, ciprofloxacin, ceftazidime, imipenem, and piperacillin, we conducted a cohort study, assessing relative risks for emergence of resistant P. aeruginosa in patients treated with any of these drugs. A total of 271 patients (followed for 3,810 days) with infections due to P. aeruginosa were treated with the study agents. Resistance emerged in 28 patients (10.2%). Adjusted hazard ratios for the emergence of resistance were as follows: ceftazidime, 0.7 (P = 0.4); ciprofloxacin, 0.8 (P = 0.6); imipenem, 2.8 (P = 0.02); and piperacillin, 1.7 (P = 0.3), Hazard ratios for emergence of resistance to each individual agent associated with treatment with the same agent were as follows: ceftazidime, 0.8 (P = 0.7); ciprofloxacin, 9.2 (P = 0.04); imipenem, 44 (P = 0.001); and piperacillin, 5.2 (P = 0.01). We concluded that there were evident differences among antibiotics in the likelihood that their use mould allow emergence of resistance in P, aeruginosa. Ceftazidime was associated with the lowest risk, and imipenem had the highest risk.