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Aydın M, Ergönül Ö, Azap A, Bilgin H, Aydın G, Çavuş SA, Demiroğlu YZ, Alışkan HE, Memikoğlu O, Menekşe Ş, Kaya Ş, Demir NA, Karaoğlan I, Başaran S, Hatipoğlu Ç, Erdinç Ş, Yılmaz E, Tümtürk A, Tezer Y, Demirkaya H, Çakar ŞE, Keske Ş, Tekin S, Yardımcı C, Karakoç Ç, Ergen P, Azap Ö, Mülazımoğlu L, Ural O, Can F, Akalın H. Rapid emergence of colistin resistance and its impact on fatality among healthcare-associated infections. J Hosp Infect 2017; 98:260-263. [PMID: 29248504 DOI: 10.1016/j.jhin.2017.11.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 11/26/2017] [Indexed: 10/18/2022]
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.
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Affiliation(s)
- M Aydın
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Başkent University, Istanbul, Turkey.
| | - Ö Ergönül
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Koç University, Istanbul, Turkey
| | - A Azap
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Ankara University, Ankara, Turkey
| | - H Bilgin
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Marmara University, Istanbul, Turkey
| | - G Aydın
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Ankara University, Ankara, Turkey; Infectious Diseases and Clinical Microbiology Department, Afyonkarahisar Training and Research Hospital, Afyonkarahisar, Turkey
| | - S A Çavuş
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Y Z Demiroğlu
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Başkent University, Adana, Turkey
| | - H E Alışkan
- Clinical Microbiology Department, School of Medicine, Başkent University, Adana, Turkey
| | - O Memikoğlu
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Ankara University, Ankara, Turkey
| | - Ş Menekşe
- Infectious Diseases and Clinical Microbiology Department, SBÜ Kartal Koşuyolu Yüksek İhtisas Hospital, Training and Research Hospital, Istanbul, Turkey
| | - Ş Kaya
- Infectious Diseases and Clinical Microbiology Department, Diyarbakır Training and Research Hospital, Diyarbakır, Turkey
| | - N A Demir
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Selçuk University, Konya, Turkey
| | - I Karaoğlan
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Gaziantep University, Gaziantep, Turkey
| | - S Başaran
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, İstanbul University, Istanbul, Turkey
| | - Ç Hatipoğlu
- Infectious Diseases and Clinical Microbiology Department, Ankara Training and Research Hospital, Ankara, Turkey
| | - Ş Erdinç
- Infectious Diseases and Clinical Microbiology Department, Ankara Training and Research Hospital, Ankara, Turkey
| | - E Yılmaz
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Uludağ University, Bursa, Turkey
| | - A Tümtürk
- Infectious Diseases and Clinical Microbiology Department, Ankara Yüksek İhtisas Training and Research Hospital, Ankara, Turkey
| | - Y Tezer
- Infectious Diseases and Clinical Microbiology Department, Ankara Yüksek İhtisas Training and Research Hospital, Ankara, Turkey
| | - H Demirkaya
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Başkent University, Ankara, Turkey
| | - Ş E Çakar
- Infectious Diseases and Clinical Microbiology Department, Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Ş Keske
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Koç University, Istanbul, Turkey
| | - S Tekin
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Koç University, Istanbul, Turkey
| | - C Yardımcı
- Infectious Diseases and Clinical Microbiology Department, Şanlıurfa Training and Research Hospital, Şanlıurfa, Turkey
| | - Ç Karakoç
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, İstinye University, Istanbul, Turkey
| | - P Ergen
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Medeniyet University, Istanbul, Turkey
| | - Ö Azap
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Başkent University, Ankara, Turkey
| | - L Mülazımoğlu
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Marmara University, Istanbul, Turkey
| | - O Ural
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Selçuk University, Konya, Turkey
| | - F Can
- Clinical Microbiology Department, School of Medicine, Koç University, Istanbul, Turkey
| | - H Akalın
- Infectious Diseases and Clinical Microbiology Department, School of Medicine, Uludağ University, Bursa, Turkey
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