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

Aydin M., Ergonul O., Azap A., Bilgin H., Aydin G., Cavus S. A., ...More

The Journal of hospital infection, vol.98, no.3, pp.260-263, 2018 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 98 Issue: 3
  • Publication Date: 2018
  • Doi Number: 10.1016/j.jhin.2017.11.014
  • Journal Name: The Journal of hospital infection
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.260-263
  • Keywords: Bloodstream, Gram-negative, Health care, Colistin MIC
  • Istanbul University Affiliated: Yes

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.