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Changes of resistance rates in Pseudomonas aeruginosa strains are unrelated to antimicrobial consumption in ICU populations with invasive device-related infection.

Abstract

OBJECTIVE

To evaluate the relationship between antipseudomonal antibiotic consumption and each individual drug resistance rate in Pseudomonas aeruginosa strains causing ICU acquired invasive device-related infections (IDRI).

DESIGN

A post hoc analysis was made of the data collected prospectively from the ENVIN-HELICS registry.

SETTING

Intensive Care Units participating in the ENVIN-UCI registry between the years 2007 and 2016 (3-month registry each year).

PATIENTS

Patients admitted for over 24h.

MAIN VARIABLES

Annual linear and nonlinear trends of resistance rates of P. aeruginosa strains identified in IDRI and days of treatment of each antipseudomonal antibiotic family per 1000 occupied ICU bed days (DOT) were calculated.

RESULTS

A total of 15,095 episodes of IDRI were diagnosed in 11,652 patients (6.2% out of a total of 187,100). Pseudomonas aeruginosa was identified in 2095 (13.6%) of 15,432 pathogens causing IDRI. Resistance increased significantly over the study period for piperacillin-tazobactam (P<0.001), imipenem (P=0.016), meropenem (P=0.004), ceftazidime (P=0.005) and cefepime (P=0.015), while variations in resistance rates for amikacin, ciprofloxacin, levofloxacin and colistin proved nonsignificant. A significant DOT decrease was observed for aminoglycosides (P<0.001), cephalosporins (P<0.001), quinolones (P<0.001) and carbapenems (P<0.001).

CONCLUSIONS

No significant association was observed between consumption of each antipseudomonal antibiotic family and the respective resistance rates for P. aeruginosa strains identified in IDRI.

Authors+Show Affiliations

Service of Intensive Care Medicine, Hospital del Mar, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain; Research Group in Critical Disorders (GREPAC), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain. Electronic address: Falvarez@parcdesalutmar.cat.Service of Intensive Care Medicine, Hospital Galdakao-Usansolo, Bizkaia, Spain.Service of Intensive Care Medicine, Hospital Universitario la Fe, Valencia, Spain.Service of Intensive Care Medicine, Hospital Universitario 12 de Octubre, Madrid, Spain.Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.Service of Intensive Care Medicine, Hospital del Mar, Spain; Research Group in Critical Disorders (GREPAC), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.Intensive Care Unit, Hospital Universitari Arnau de Vilanova, Lleida, Spain.Service of Intensive Care Medicine, Hospital de Cruces, Barakaldo, Bizkaia, Spain.Unit of Biostatistics, Institut de Recerca Biomèdica de Lleida (IRBLLEIDA) and Department of Basic Medical Sciencies, Universitat de Lleida, Lleida, Spain.No affiliation info available

Pub Type(s)

Journal Article

Language

eng spa

PubMed ID

31787354

Citation

Álvarez-Lerma, F, et al. "Changes of Resistance Rates in Pseudomonas Aeruginosa Strains Are Unrelated to Antimicrobial Consumption in ICU Populations With Invasive Device-related Infection." Medicina Intensiva, 2019.
Álvarez-Lerma F, Olaechea-Astigarraga P, Gimeno R, et al. Changes of resistance rates in Pseudomonas aeruginosa strains are unrelated to antimicrobial consumption in ICU populations with invasive device-related infection. Med Intensiva. 2019.
Álvarez-Lerma, F., Olaechea-Astigarraga, P., Gimeno, R., Catalan, M., Nuvials, X., Gracia-Arnilla, M. P., ... Martínez-Alonso, M. (2019). Changes of resistance rates in Pseudomonas aeruginosa strains are unrelated to antimicrobial consumption in ICU populations with invasive device-related infection. Medicina Intensiva, doi:10.1016/j.medin.2019.09.020.
Álvarez-Lerma F, et al. Changes of Resistance Rates in Pseudomonas Aeruginosa Strains Are Unrelated to Antimicrobial Consumption in ICU Populations With Invasive Device-related Infection. Med Intensiva. 2019 Nov 28; PubMed PMID: 31787354.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changes of resistance rates in Pseudomonas aeruginosa strains are unrelated to antimicrobial consumption in ICU populations with invasive device-related infection. AU - Álvarez-Lerma,F, AU - Olaechea-Astigarraga,P, AU - Gimeno,R, AU - Catalan,M, AU - Nuvials,X, AU - Gracia-Arnilla,M P, AU - Palomar-Martínez,M, AU - Seijas-Betolaza,I, AU - Martínez-Alonso,M, AU - ,, Y1 - 2019/11/28/ PY - 2019/06/14/received PY - 2019/08/29/revised PY - 2019/09/22/accepted PY - 2019/12/3/entrez PY - 2019/12/4/pubmed PY - 2019/12/4/medline KW - Antibiotic resistance KW - Antibióticos antipseudomonales KW - Antipseudomonal antimicrobials KW - Critically ill KW - ICU KW - Infecciones relacionadas con dispositivos invasivos KW - Invasive device-related infections (IDRI) KW - Paciente crítico KW - Pseudomonas aeruginosa KW - Resistencia a antibióticos KW - Unidad de Cuidados Intensivos JF - Medicina intensiva JO - Med Intensiva N2 - OBJECTIVE: To evaluate the relationship between antipseudomonal antibiotic consumption and each individual drug resistance rate in Pseudomonas aeruginosa strains causing ICU acquired invasive device-related infections (IDRI). DESIGN: A post hoc analysis was made of the data collected prospectively from the ENVIN-HELICS registry. SETTING: Intensive Care Units participating in the ENVIN-UCI registry between the years 2007 and 2016 (3-month registry each year). PATIENTS: Patients admitted for over 24h. MAIN VARIABLES: Annual linear and nonlinear trends of resistance rates of P. aeruginosa strains identified in IDRI and days of treatment of each antipseudomonal antibiotic family per 1000 occupied ICU bed days (DOT) were calculated. RESULTS: A total of 15,095 episodes of IDRI were diagnosed in 11,652 patients (6.2% out of a total of 187,100). Pseudomonas aeruginosa was identified in 2095 (13.6%) of 15,432 pathogens causing IDRI. Resistance increased significantly over the study period for piperacillin-tazobactam (P<0.001), imipenem (P=0.016), meropenem (P=0.004), ceftazidime (P=0.005) and cefepime (P=0.015), while variations in resistance rates for amikacin, ciprofloxacin, levofloxacin and colistin proved nonsignificant. A significant DOT decrease was observed for aminoglycosides (P<0.001), cephalosporins (P<0.001), quinolones (P<0.001) and carbapenems (P<0.001). CONCLUSIONS: No significant association was observed between consumption of each antipseudomonal antibiotic family and the respective resistance rates for P. aeruginosa strains identified in IDRI. SN - 1578-6749 UR - https://www.unboundmedicine.com/medline/citation/31787354/Changes_of_resistance_rates_in_Pseudomonas_aeruginosa_strains_are_unrelated_to_antimicrobial_consumption_in_ICU_populations_with_invasive_device-related_infection L2 - http://www.elsevier.es/en/linksolver/ft/pii/S0210-5691(19)30242-6 DB - PRIME DP - Unbound Medicine ER -