Health and economic outcomes of antibiotic resistance in Pseudomonas aeruginosa.

Détails

ID Serval
serval:BIB_90461BAEDFC6
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Health and economic outcomes of antibiotic resistance in Pseudomonas aeruginosa.
Périodique
Archives of Internal Medicine
Auteur(s)
Carmeli Y., Troillet N., Karchmer A.W., Samore M.H.
ISSN
0003-9926 (Print)
ISSN-L
0003-9926
Statut éditorial
Publié
Date de publication
1999
Peer-reviewed
Oui
Volume
159
Numéro
10
Pages
1127-1132
Langue
anglais
Notes
Publication types: Journal Article
Résumé
BACKGROUND: Antimicrobial resistance is an increasing problem.
OBJECTIVE: To examine the clinical and economic impact of antibiotic resistance in Pseudomonas aeruginosa.
METHODS: In-hospital mortality, secondary bacteremia, length of stay, and hospital charges were examined in a cohort of 489 inpatients with positive clinical cultures for P aeruginosa. One hundred forty-four had a resistant baseline P aeruginosa isolate and 30 had resistance emerge during follow-up. Multivariable and survival analytic methods were used to adjust for confounding and effects of time.
RESULTS: The overall in-hospital mortality rate was 7.6%, 7.7% in patients with a resistant isolate at baseline (relative risk [RR], 1.3; 95% confidence interval [CI], 0.6-2.8) and 27% in patients in whom resistance emerged (RR, 3.0; 95% CI, 1.2-7.8). Secondary bacteremia developed in 1.4% of patients in whom resistance did not emerge and in 14% of those in whom resistance emerged (RR, 9.0; 95% CI, 2.7-30). The median duration of hospital stay following the initial P aeruginosa isolate was 7 days. Emergence of resistance, but not baseline resistance, was significantly associated with a longer hospital stay (P<.001 and P=.71, respectively). The average daily hospital charge was $2059. Neither baseline resistance nor emergence of resistance had a significant effect on the daily hospital charge. In a matched cohort analysis, a trend was seen toward increased total charges in patients demonstrating emergence of resistance (difference, $7340; P=.14).
CONCLUSIONS: Emergence of antibiotic resistance in P aeruginosa results in severe adverse outcomes. Efforts should be directed toward early detection and prevention of emergence of antibiotic resistance.
Mots-clé
Adult, Aged, Bacteremia/microbiology, Boston, Drug Resistance, Microbial, Female, Hospital Bed Capacity, 300 to 499, Hospital Charges, Hospital Mortality, Hospitals, Teaching/economics, Hospitals, Teaching/utilization, Humans, Length of Stay, Male, Middle Aged, Pseudomonas Infections/drug therapy, Pseudomonas Infections/economics, Pseudomonas aeruginosa/drug effects, Risk
Pubmed
Création de la notice
28/12/2013 18:44
Dernière modification de la notice
03/03/2018 19:24
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