Imipenen-resistant Ps. aeruginosa bacteraemia in cancer patients: risk factors, clinical features and outcome.
Ninety-nine patients with 101 bacteraemic episodes due to Pseudomonas aeruginosa (PA) within 6 years were divided into two groups according to their resistance to imipenem; of these 91 episodes were due to imipenem-sensitive (ISPA) and 10 due to imipenem-resistant (IRPA) strains. Risk factors, clinical course and outcome were evaluated and compared in the two groups. Acute leukaemia, long-lasting neutropenia, previous therapy with amikacin, third-generation cephalosporins, imipenem and prophylaxis with quinolones were significantly more frequently associated with IRPA than with ISPA. Imipenem-resistant PA bactereamias were associated with a higher incidence of septic shock (40% vs 19.8%) p. 161 0.02) and death 33.3%) than were ISPA bacteraemias. Since 1992, when first IRPA appeared, the incidence of imipenem-resistance increased tenfold, and in 1994, up to 10% of the PA populations causing bloodstream infections in cancer patients in our centre were imipenem-resistant.
Krcmery
V
V
Dept. of Medicine, University of Trnava, Slovakia.
Trup
J
J
Kunova
A
A
Spanik
S
S
Drgona
L
L
Oravcova
E
E
Studena
M
M
Lacka
J
J
Sevcikova
L
L
Koren
P
P
Kukuckova
E
E
Stopkova
K
K
Krupova
I
I
Grausova
S
S
Svec
J
J
D000328:Adult; D016470:Bacteremia / Q000453:epidemiology* / Q000209:etiology; D002173:Cancer Care Facilities; D004352:Drug Resistance, Microbial; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use*; D015994:Incidence; D009369:Neoplasms / Q000150:complications*; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D012307:Risk Factors; D012772:Shock, Septic / Q000453:epidemiology; D018154:Slovakia; D013845:Thienamycins / Q000627:therapeutic use*
D013845:Thienamycins; D015378:Imipenem