Risk factors for infection with colistin-resistant gram-negative microorganisms: a multicenter study
Date
2016Author
Yilmaz, Gul R.Dizbay, Murat
Guven, Tumer
Pullukcu, Husnu
Tasbakan, Meltem
Guzel, Ozlem Tunccan
Tekce, Yasemin T.
Ozden, Mehmet
Turhan, Ozge
Guner, Rahmet
Cag, Yasemin
Bozkurt, Fatma
Karadag, Fatma Yilmaz
Kartal, Elif Doyuk
Gozel, Gokhan
Bulut, Cemal
Erdinc, Sebnem
Keske, Siran
Acikgoz, Ziya Cibali
Tasyaran, Mehmet A.
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BACKGROUND: Knowing risk factors for colistin resistance is important since colistin is the only remaining choice for the treatment of infections caused by multi-drug resistant microorganisms. OBJECTIVE: Evaluate risk factors associated with infection by colistin-resistant microorganisms. DESIGN: Retrospective study. SETTINGS: Tertiary healthcare centers. PATIENTS AND METHODS: An e-mail including the title and purpose of the study was sent to 1500 infectious disease specialists via a scientific and social web portal named "Infeksiyon Dunyasi (Infection World)". Demographic and clinical data was requested from respondents. MAIN OUTCOME MEASURE(S): Colistin-resistance. RESULTS: Eighteen infectious disease specialists from twelve tertiary care centers responded to the invitation. Data was collected on 165 patients, 56 cases (39.9%) and 109 (66.0%) age-and sex-matched controls. The colistin-resistant microorganisms isolated from cases were 29 Acinetobacter baumannii (51.8%), 18 Pseudomonas aeruginosa (32.1%) and 9 Klebsiella spp. Colistin, carbapenem, and quinolone use in the last three months were risk factors for colistin resistance in the univariate analysis. Previous quinolone use in the last three months (P=.003; RR: 3.2; 95% CI: 1.5-6,7) and previous colistin use in the last three months (P=.001; RR: 3.6; 95% CI: 1.63-7.99) were significant risk factors in the multivariate analysis. CONCLUSION: Clinicians should limit the use of quinolones and remain aware of the possibility of resistance developing during colistin use. LIMITATIONS: The lack of a heteroresistance analysis on the isolates. No data on use of a loading dose or the use of colistin in combination.
Source
ANNALS OF SAUDI MEDICINEVolume
36Issue
3Collections
- Makale Koleksiyonu [5200]
- Makale Koleksiyonu [5745]
- Öksüz Yayınlar Koleksiyonu - WoS [6162]