Emergence of antimicrobial resistance to Pseudomonas aeruginosa in the intensive care unit: association with the duration of antibiotic exposure and mode of administration
Abstract Background Antibiotics are frequently used in intensive care units (ICUs), and their use is associated with the emergence of bacterial resistance to antibiotics. The aim of this study was to investigate the association between the emergence of Pseudomonas aeruginosa resistance and the durat...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2017-06-01
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| Series: | Annals of Intensive Care |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13613-017-0296-z |
| _version_ | 1830140841390243840 |
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| author | Erlangga Yusuf Bruno Van Herendael Walter Verbrugghe Margareta Ieven Emiel Goovaerts Kristof Bergs Kristien Wouters Philippe G. Jorens Herman Goossens |
| author_facet | Erlangga Yusuf Bruno Van Herendael Walter Verbrugghe Margareta Ieven Emiel Goovaerts Kristof Bergs Kristien Wouters Philippe G. Jorens Herman Goossens |
| author_sort | Erlangga Yusuf |
| collection | DOAJ |
| description | Abstract Background Antibiotics are frequently used in intensive care units (ICUs), and their use is associated with the emergence of bacterial resistance to antibiotics. The aim of this study was to investigate the association between the emergence of Pseudomonas aeruginosa resistance and the duration of antibiotic exposure or mode of administration in an ICU unit. Methods A 4-year cohort study of intensive care unit was performed in patients with P. aeruginosa isolates from clinical specimens, initially susceptible to the investigated antibiotics (piperacillin/tazobactam, ceftazidime, ciprofloxacin, meropenem and amikacin). Odds ratios (ORs) with 95% confidence interval (95% CI) of emergence of resistance were calculated using logistic regression analysis for various exposure periods to antibiotics (1–3, 4–7, 8–15 and >15 days) relative to no exposure with adjustment for age, sex, Simplified Acute Physiology Score 3 (SAPS 3) and length of stay. ORs on the emergence of P. aeruginosa resistance were also calculated for the various modes of administration. Results Included were 187 patients [mean age 61 years, 69% male, mean SAPS 3 score (SD): 59 (12.3)]. None of the antibiotics investigated showed the emergence of resistance within 1–3 days. Significant meropenem resistance emerged within 8–15 days [OR 79.1 (14.9–421.0)] after antibiotic exposure unlike other antibiotics (>15 days). No difference was observed between intermittent and extended administration of meropenem and between beta-lactam mono- or combined therapy. Conclusions Use of meropenem was associated with the emergence of resistance as soon as 8 days after exposure to the antibiotic. |
| first_indexed | 2024-12-17T09:10:09Z |
| format | Article |
| id | doaj.art-73bab00cd70f429f9f3795635c8f8bb9 |
| institution | Directory Open Access Journal |
| issn | 2110-5820 |
| language | English |
| last_indexed | 2024-12-17T09:10:09Z |
| publishDate | 2017-06-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Annals of Intensive Care |
| spelling | doaj.art-73bab00cd70f429f9f3795635c8f8bb92022-12-21T21:55:15ZengSpringerOpenAnnals of Intensive Care2110-58202017-06-01711710.1186/s13613-017-0296-zEmergence of antimicrobial resistance to Pseudomonas aeruginosa in the intensive care unit: association with the duration of antibiotic exposure and mode of administrationErlangga Yusuf0Bruno Van Herendael1Walter Verbrugghe2Margareta Ieven3Emiel Goovaerts4Kristof Bergs5Kristien Wouters6Philippe G. Jorens7Herman Goossens8Department of Microbiology, Antwerp University Hospital (UZA), University of AntwerpDepartment of Microbiology, Antwerp University Hospital (UZA), University of AntwerpDepartment of Intensive Care Medicine, Antwerp University Hospital (UZA), University of AntwerpDepartment of Microbiology, Antwerp University Hospital (UZA), University of AntwerpDepartment of Hospital Hygiene and Infection Control, Antwerp University Hospital (UZA), University of AntwerpDepartment of Intensive Care Medicine, Antwerp University Hospital (UZA), University of AntwerpDepartment of Biostatistics, Antwerp University Hospital (UZA), University of AntwerpDepartment of Intensive Care Medicine, Antwerp University Hospital (UZA), University of AntwerpDepartment of Microbiology, Antwerp University Hospital (UZA), University of AntwerpAbstract Background Antibiotics are frequently used in intensive care units (ICUs), and their use is associated with the emergence of bacterial resistance to antibiotics. The aim of this study was to investigate the association between the emergence of Pseudomonas aeruginosa resistance and the duration of antibiotic exposure or mode of administration in an ICU unit. Methods A 4-year cohort study of intensive care unit was performed in patients with P. aeruginosa isolates from clinical specimens, initially susceptible to the investigated antibiotics (piperacillin/tazobactam, ceftazidime, ciprofloxacin, meropenem and amikacin). Odds ratios (ORs) with 95% confidence interval (95% CI) of emergence of resistance were calculated using logistic regression analysis for various exposure periods to antibiotics (1–3, 4–7, 8–15 and >15 days) relative to no exposure with adjustment for age, sex, Simplified Acute Physiology Score 3 (SAPS 3) and length of stay. ORs on the emergence of P. aeruginosa resistance were also calculated for the various modes of administration. Results Included were 187 patients [mean age 61 years, 69% male, mean SAPS 3 score (SD): 59 (12.3)]. None of the antibiotics investigated showed the emergence of resistance within 1–3 days. Significant meropenem resistance emerged within 8–15 days [OR 79.1 (14.9–421.0)] after antibiotic exposure unlike other antibiotics (>15 days). No difference was observed between intermittent and extended administration of meropenem and between beta-lactam mono- or combined therapy. Conclusions Use of meropenem was associated with the emergence of resistance as soon as 8 days after exposure to the antibiotic.http://link.springer.com/article/10.1186/s13613-017-0296-zPseudomonas aeruginosaAntibiotic resistanceExtended infusion |
| spellingShingle | Erlangga Yusuf Bruno Van Herendael Walter Verbrugghe Margareta Ieven Emiel Goovaerts Kristof Bergs Kristien Wouters Philippe G. Jorens Herman Goossens Emergence of antimicrobial resistance to Pseudomonas aeruginosa in the intensive care unit: association with the duration of antibiotic exposure and mode of administration Annals of Intensive Care Pseudomonas aeruginosa Antibiotic resistance Extended infusion |
| title | Emergence of antimicrobial resistance to Pseudomonas aeruginosa in the intensive care unit: association with the duration of antibiotic exposure and mode of administration |
| title_full | Emergence of antimicrobial resistance to Pseudomonas aeruginosa in the intensive care unit: association with the duration of antibiotic exposure and mode of administration |
| title_fullStr | Emergence of antimicrobial resistance to Pseudomonas aeruginosa in the intensive care unit: association with the duration of antibiotic exposure and mode of administration |
| title_full_unstemmed | Emergence of antimicrobial resistance to Pseudomonas aeruginosa in the intensive care unit: association with the duration of antibiotic exposure and mode of administration |
| title_short | Emergence of antimicrobial resistance to Pseudomonas aeruginosa in the intensive care unit: association with the duration of antibiotic exposure and mode of administration |
| title_sort | emergence of antimicrobial resistance to pseudomonas aeruginosa in the intensive care unit association with the duration of antibiotic exposure and mode of administration |
| topic | Pseudomonas aeruginosa Antibiotic resistance Extended infusion |
| url | http://link.springer.com/article/10.1186/s13613-017-0296-z |
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