Clinical and bacteriological characteristics of IMP-type metallo-beta-lactamase-producing Pseudomonas aeruginosa.
IMP-type metallo-beta-lactamase-producing bacteria have recently emerged worldwide. We conducted a case-control study in which 69 inpatients harboring bla(IMP)-positive Pseudomonas aeruginosa and 247 control subjects with bla(IMP)-negative pathogens were investigated. Prolonged hospitalization, antineoplastic chemotherapy, corticosteroid therapy (P=.001), and indwelling urinary catheters (P=.04) were risk factors for isolation of bla(IMP)-positive pathogens. The predominant source was urine (P=.001). The duration of antibiotic treatment and the total dose (including of carbapenems) were significantly greater among case patients than among control subjects (P<.01). bla(IMP)-positive P. aeruginosa isolates were more frequently resistant to multiple drugs (P=.001) and caused more infections (P=.001) than bla(IMP)-negative pathogens. There were no significant differences in bacteriological outcome (P=.94); however, infection-related death was more frequent among case patients than among control subjects (P=.023). These results suggest that precautionary measures against the spread of bla(IMP)-positive isolates are needed, because, for most of such pathogens, no antibiotic is potent enough to be used as a single agent in treatment of infection.
Hirakata
Yoichi
Y
Department of Laboratory Medicine, Atomic Bomb Disease Institute, Nagasaki University School of Medicine, Nagasaki, Japan. hirakata@net.nagasaki-u.ac.jp
Yamaguchi
Toshiyuki
T
Nakano
Michiko
M
Izumikawa
Koichi
K
Mine
Mariko
M
Aoki
Shiho
S
Kondoh
Akira
A
Matsuda
Junichi
J
Hirayama
Mitsukuni
M
Yanagihara
Katsunori
K
Miyazaki
Yoshitsugu
Y
Tomono
Kazunori
K
Yamada
Yasuaki
Y
Kamihira
Shimeru
S
Kohno
Shigeru
S
D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016022:Case-Control Studies; D006801:Humans; D008826:Microbial Sensitivity Tests; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000201:enzymology*; D018440:beta-Lactam Resistance / Q000502:physiology*; D001618:beta-Lactamases / Q000032:analysis*
D000900:Anti-Bacterial Agents; C409201:beta-lactamase IMP-1; D001618:beta-Lactamases