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Faktori rizika za nastanak bolničkih infekcija uzrokovanih Pseudomonas aeruginosa rezistentnim na cefepim
aKlinički centar Kragujevac, Služba za kliničku farmakologiju + Univerzitet u Kragujevcu, Medicinski fakultet
bKlinički centar Kragujevac, Klinika za infektivne bolesti
cKlinički centar Kragujevac, Služba za kliničku farmakologiju

e-adresaslobnera@gmail.com
Projekat:
Farmakološka analiza efekata biološki aktivnih supstanci na izolovane glatke mišiće gastrointestinalnog i urogenitalnog trakta čoveka (MPNTR - 175007)

Sažetak
Uvod: Porast rezistencije Pseudomonas aeruginosa na cefepim zahteva bolje razumevanje bolničke epidemiologije u cilju zadržavanja ovog medikamenta kao adekvatne terapijske opcije. Cilj: Cilj ove studije bazirao se na identifikaciji faktora rizika udruženih sa razvojem bolničkih infekcija uzrokovanih P. aeruginosa rezistentnim na cefepim, kako kod svih bolesnika sa infekcijama ovog tipa, tako i kod podgrupe pacijenata sa letalnim ishodom i podgrupe onih koji su razvili infekciju uzrokovanu P. aeruginosa otpornim na karbapeneme. Metod: Ova akademska studija je dizajnirana kao kombinacija tri "ugnježdene" studije tipa slučaj/kontrola u okviru kohorte pacijenata sa bolničkim infekcijama uzrokovanim P. aeruginosa bez obzira na lokaciju, prospektivno praćene u periodu od januara 2009. do decembra 2017. godine u ustanovi tercijarnog nivoa zdravstvene zaštite. Uticaj faktora rizika na specifične ishode procenjivan je na osnovu prilagođenih odnosa šansi izračunatih iz multivarijantnih logističkih regresija. Rezultati: Naše istraživanje je pokazalo da su nezavisni faktori rizika za nastanak infekcija uzrokovanih P. aeruginosa rezistentnim na cefepim prisustvo dodatne intrahospitalne infekcije kod pacijenta (p=0,001), hospitalizacija u jednici intenzivne nege duža od jednog meseca (p=0,007), duže vreme hospitalizacije pre nastanka infekcije (p=0,004), dugotrajna primena mehaničke ventilacije (p=0,036), primena antibiotika pre razvoja infekcije (p<0,001) i prethodna upotreba fluorohinolona (p=0,030), dok su traumatske povrede (p = 0,020), postojanje dodatne bolničke infekcije (p=0,001) i dugotrajna primena antibiotika pre razvoja bolničke infekcije (p=0,034) povezane sa smrtnošću. Nezavisni faktori rizika za razvoj intrahospitalnih infekcija uzrokovanih P. aeruginosa rezistentnim na cefepim koji je ujedno otporan i na karbapeneme su postojanje dodatne intrahospitalne infekcije (p=0,011), prelazak pacijenta iz druge organizacione jedinice (p=0,023), duži period boravka u bolnici (p=0,006) i jedinici intenzivne nege (p=0,004) i primena antibiotika pre razvoja infekcije (p<0,001). Zaključak: Faktori rizika za razvoj bolničkih infekcija uzrokovanih P. aeruginosa rezistentnim na cefepim primarno su povezani sa primenom sistemskih antibiotika pre razvoja infekcije, što dovodi do selekcije multi, ekstenzivnih ili pan-rezistentnih sojeva P. aeruginosa koji napadaju tkiva i izazivaju infekciju.
Reference
Akhabue, E., Synnestvedt, M., Weiner, M.G., Bilker, W.B., Lautenbach, E. (2011) Cefepime-resistant Pseudomonas aeruginosa. Emerging Infectious Diseases, 17(6), 1037-1043
Athanasiou, C.I., Kopsini, A. (2018) Systematic review of the use of time series data in the study of antimicrobial consumption and Pseudomonas aeruginosa resistance. Journal of Global Antimicrobial Resistance, 15, 69-73
Bosman, A., de Jong, M.B., Debeij, J., van den Broek, P.J., Schipper, I.B. (2012) Systematic review and meta-analysis of antibiotic prophylaxis to prevent infections from chest drains in blunt and penetrating thoracic injuries. British Journal of Surgery, 99(4), 506-513
Boucher, H.W., Talbot, G.H., Bradley, J.S., Edwards, J.E., Gilbert, D., Rice, L.B., Scheld, M., Spellberg, B., Bartlett, J. (2009) Bad bugs, no drugs: No ESKAPE!: An update from the Infectious Diseases Society of America. Clinical Infectious Diseases, 48(1), 1-12
CLSI: Clinical and Laboratory Standard Institute (CLSI) (2010) Performance standards for antimicrobial susceptibility testing. Wayne, PA, USA
Dantas, R.C., Ferreira, M.L., Gontijo-Filho, P.P., Ribas, R.M. (2014) Pseudomonas aeruginosa bacteraemia: Independent risk factors for mortality and impact of resistance on outcome. Journal of Medical Microbiology, 63(Pt 12), 1679-1687
Drusano, G.L., Bonomo, R.A., Bahniuk, N., Bulitta, J.B., Vanscoy, B., Defiglio, H., Fikes, S., Brown, D., Drawz, S.M., Kulawy, R., Louie, A. (2012) Resistance emergence mechanism and mechanism of resistance suppression by tobramycin for cefepime for Pseudomonas aeruginosa. Antimicrobial Agents and Chemotherapy, 56(1), 231-242
Garner, J.S., Jarvis, W.R., Emori, G.T., Horan, T.C., Hughes, J.M. (1988) CDC definitions for nosocomial infections. American Journal of Infection Control, 16(3), 128-140
Glance, L.G., Stone, P.W., Mukamel, D.B., Dick, A.W. (2011) Increases in mortality, length of stay, and cost associated with hospital-acquired infections in trauma patients. Archives of Surgery, 146(7), 794-801
Gupta, R., Malik, A., Rizvi, M., Ahmed, S.M. (2016) Incidence of multidrug-resistant Pseudomonas spp. in ICU patients with special reference to ESBL, AMPC, MBL and biofilm production. J Glob Infect Dis, 8, 25-31
Kiska, D.L., Gilligan, P.H. (1995) Pseudomonas and Burkholderia. u: Murray P.R., Baron E.J., Pfaller M.A., Tenover F.C., Yolken R.H. [ur.] Manual of clinical microbiology, Washington: American Society for Microbiology, p. 517-25
Lucena, A., Dalla, C.L.M., Nogueira, K.S., Matos, A.P., Gales, A.C., Paganini, M.C., Castro, M.E.S., Raboni, S.M. (2014) Nosocomial infections with metallo-beta-lactamase-producing Pseudomonas aeruginosa: Molecular epidemiology, risk factors, clinical features and outcomes. Journal of Hospital Infection, 87(4), 234-240
Magiorakos, A.P., Srinivasan, A., Carey, R.B., Carmeli, Y., Falagas, M.E., Giske, C.G., Harbarth, S., Hindler, J.F., Kahlmeter, G., Olsson-Liljequist, B., Paterson, D.L., Rice, L.B., Stelling, J., Struelens, M.J., Vatopoulos, A., Weber, J.T., Monnet, D.L. (2012) Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: An international expert proposal for interim standard definitions for acquired resistance. Clinical microbiology and infection, 18(3), 268-281
Montgomerie, J.Z. (1997) Infections in Patients with Spinal Cord Injuries. Clinical Infectious Diseases, 25(6), 1285-1290
Nasiri, M.I., Naqvi, S.B.S., Zaidi, A.A., Saeed, R., Raza, G. (2013) Comparative study on resistant pattern of clinical isolates against levofloxacin and cefepime. Pak J Pharm Sci, 26(2), 415-419
Nathwani, D., Raman, G., Sulham, K., Gavaghan, M., Menon, V. (2014) Clinical and economic consequences of hospital-acquired resistant and multidrug-resistant Pseudomonas aeruginosa infections: A systematic review and meta-analysis. Antimicrobial Resistance and Infection Control, 3(1), 32
Nouér, S.A., Nucci, M., De-Oliveira, M.P., Pellegrino, F.L.P.C., Moreira, B.M. (2005) Risk factors for acquisition of multidrug-resistant Pseudomonas aeruginosa producing SPM metallo-beta-lactamase. Antimicrob Agents Chemother, 49(9), 3663-3667
Radan, M., Moniri, R., Khorshidi, A., Gilasi, H., Norouzi, Z., Beigi, F., Dasteh, G.Y. (2016) Emerging Carbapenem-Resistant Pseudomonas aeruginosa Isolates Carrying blaIMP Among Burn Patients in Isfahan, Iran. Archives of Trauma Research, 5(3), 33664-33664
Rello, J., Allegri, C., Rodriguez, A., Vidaur, L., Sirgo, G., Gomez, F., Agbaht, K., Pobo, A., Diaz, E. (2006) Risk factors for ventilator-associated pneumonia by Pseudomonas aeruginosa in presence of recent antibiotic exposure. Anesthesiology, 105(4), 709-714
Vincent, J.L., Rello, J., Marshall, J., Silva, E., Anzueto, A., Martin, C.D., et al. (2009) International study of the prevalence and outcomes of infection in intensive care units. JAMA, 302(21), 2323-2329
Wanis, M., Walker, S.A.N., Daneman, N., Elligsen, M., Palmay, L., Simor, A., Cartotto, R. (2016) Impact of hospital length of stay on the distribution of Gram negative bacteria and likelihood of isolating a resistant organism in a Canadian burn center. Burns, 42(1), 104-111
Xiao, H., Ye, X., Liu, Q., Li, L.I. (2013) Antibiotic susceptibility and genotype patterns of Pseudomonas aeruginosa from mechanical ventilation-associated pneumonia in intensive care units. Biomedical Reports, 1(4), 589-593
Yahav, D., Paul, M., Fraser, A., Sarid, N., Leibovici, L. (2007) Efficacy and safety of cefepime: A systematic review and meta-analysis. Lancet Infect Dis, 7(5), 338-348
Zavascki, A.P., Barth, A.L., Gaspareto, P.B., Gonçalves, A.L.S., Moro, A.L.D., Fernandes, J.F., et al. (2006) Risk factors for nosocomial infections due to Pseudomonas aeruginosa producing metallo-b-lactamase in two tertiary-care teaching hospitals. Journal of Antimicrobial Chemotherapy, 58(4), 882-885
Zhao, X.F., Yuan, M., Chen, X., Liu, X.F., Yu, D.S., Li, J. (2017) Drug resistance and dissemination of New Delhi metallob-lactamase 1 positive bacteria in a patient. Zhonghua Yu Fang Yi Xue Za Zhi, 51(10), 890-895, (Article in Chinese with an abstract in English)
Zhou, F., Li, H., Gu, L., Liu, M., Xue, C., Cao, B., Wang, C. (2018) Risk factors for nosocomial infection among hospitalised severe influenza A(H1N1)pdm09 patients. Respiratory Medicine, 134, 86-91
 

O članku

jezik rada: engleski
vrsta rada: originalan članak
DOI: 10.5937/hpimj2002923F
objavljen u SCIndeksu: 18.09.2020.
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