title: Influence of carbapenem resistance on mortality of patients with Pseudomonas aeruginosa infection: a meta-analysis.
abstract: Treatment of infectious diseases caused by the carbapenem-resistant Pseudomonas aeruginosa (CRPA) is becoming more challenging with each passing year. We conducted a meta-analysis to assess the impact of carbapenem resistance on mortality of patients with P. aeruginosa infection. We searched PUBMED, Web of science, EMBASE, Google Scholar and the Cochrane Library up to December 25, 2014, to identify published cohort or case-control studies. 17 studies, including 6660 patients carrying P. aeruginosa, were identified. The pooling analysis indicated that patients infected with CRPA had significantly higher mortality than those infected with carbapenem-susceptible P. aeruginosa (CSPA) (crude OR = 1.64; 95%CI = 1.40, 1.93; adjusted OR = 2.38; 95%CI = 1.53, 3.69). The elevated risk of mortality in patients with CRPA infection was not lessened when stratified by study design, sites of infection, or type of carbapenem, except that the estimate effect vanished in CRPA high-incidence region, South America (crude OR = 1.12; 95%CI = 0.64, 1.99). Begg's (z = 0.95, p = 0.34) and Egger's test (t = 1.23, p = 0.24) showed no evidence of publication bias. Our results suggest that carbapenem resistance may increase the mortality of patients with P. aeruginosa infection, whether under univariate or multivariate analysis.
authors.affiliation: Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China.
authors.forename: Qianqian
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Collaborative Innovation Center of Sichuan for Elder Care and Health, Chengdu Medical College, Chengdu, Sichuan, 610500, China.
authors.forename: Xiaoqing
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, 610500, China.
authors.forename: Wenzhang
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China.
authors.forename: Xinmiao
authors.initials: X
authors.lastname: Du
authors.affiliation: Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China.
authors.forename: Jian-Qing
authors.initials: JQ
authors.lastname: He
authors.affiliation: Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China.
authors.forename: Chuanmin
authors.initials: C
authors.lastname: Tao
authors.affiliation: Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China.
authors.forename: Yulin
authors.initials: Y
authors.lastname: Feng
mesh_terms: D015780:Carbapenems / Q000494:pharmacology* / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D006801:Humans; D015999:Multivariate Analysis; D016017:Odds Ratio; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality*; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000502:physiology; D015996:Survival Rate
chemical_list: D015780:Carbapenems