Rapid Emergence of Colistin Resistance and Its Impact on Fatality Among Healthcare-Associated Infections
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Date
2018
Authors
Aydin, M.
Ergonul, O.
Azap, A.
Bilgin, H.
Aydin, G.
Cavus, S. A.
Demiroglu, Y. Z.
Aliskan, H. E.
Memikoglu, O.
Menekse, S.
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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.
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Keywords
Bloodstream, Gram-negative, Health care, Colistin MIC