title: Risk factors for infection with colistin-resistant gram-negative microorganisms: a multicenter study.
abstract: BACKGROUND
  Knowing risk factors for colistin resistance is important since colistin is the only remaining choice for the treatment of infections caused by multi-drug resistant microorganisms.
  
  
  OBJECTIVE
  Evaluate risk factors associated with infection by colistin-resistant microorganisms.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Tertiary healthcare centers.
  
  
  METHODS
  An e-mail including the title and purpose of the study was sent to 1500 infec.tious disease specialists via a scientific and social web portal named "infeksiyon dunyasi (infection world)". Demographic and clinical data was requested from respondents.
  
  
  METHODS
  Colistin-resistance.
  
  
  RESULTS
  Eighteen infectious disease specialists from twelve tertiary care centers responded to the invitation data was collected on 165 patients, 56 cases (39.9%) and 109 (66.0%) age- and sex-matched controls. The colistin-resistant microorganisms isolated from cases were 29 Acinetobacter baumannii (51.8%), 18 Pseudomonas aeruginosa (32.1%) and 9 Klebsiella spp. Colistin, carbapenem, and quinolone use in the last three months were risk factors for colistin resistance in the univariate analysis. Previous quinolone use in the last three months (P=.003; RR:3.2; 95% Ci:1.5-6,7) and previous colistin use in the last three months (P=.001; RR: 3.6; 95% CI: 1.63-7.99) were significant risk factors in the multivariate analysis.
  
  
  CONCLUSIONS
  Clinicians should limit the use of quinolones and remain aware of the possibility of resistance developing during colistin use.
  
  
  CONCLUSIONS
  The lack of a heteroresistance analysis on the isolates. no data on use of a loading dose or the use of colistin in combination.
authors.affiliation: Associate Prof. Gul R. Yilmaz, TR Ministry of Health,, Ankara Ataturk Training and Research Hospital, Infectious Diseases and Clinical Microbiology,, Bilkent Cad. no. 3 Ankara 06800, Turkey, T: 00903122912525,, F: 00903124269393, rruhsar6@yahoo.com, ORCID ID: orcid.org/0000-0001-5878-4301.
authors.forename: Gul R
authors.initials: GR
authors.lastname: Yilmaz
authors.forename: Murat
authors.initials: M
authors.lastname: Dizbay
authors.forename: Tumer
authors.initials: T
authors.lastname: Guven
authors.forename: Husnu
authors.initials: H
authors.lastname: Pullukcu
authors.forename: Meltem
authors.initials: M
authors.lastname: Tasbakan
authors.forename: Ozlem Tunccan
authors.initials: OT
authors.lastname: Guzel
authors.forename: Yasemin T
authors.initials: YT
authors.lastname: Tekce
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ozden
authors.forename: Ozge
authors.initials: O
authors.lastname: Turhan
authors.forename: Rahmet
authors.initials: R
authors.lastname: Guner
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Cag
authors.forename: Fatma
authors.initials: F
authors.lastname: Bozkurt
authors.forename: Fatma Yilmaz
authors.initials: FY
authors.lastname: Karadag
authors.forename: Elif Doyuk
authors.initials: ED
authors.lastname: Kartal
authors.forename: Gokhan
authors.initials: G
authors.lastname: Gozel
authors.forename: Cemal
authors.initials: C
authors.lastname: Bulut
authors.forename: Sebnem
authors.initials: S
authors.lastname: Erdinc
authors.forename: Siran
authors.initials: S
authors.lastname: Keske
authors.forename: Ziya Cibali
authors.initials: ZC
authors.lastname: Acikgoz
authors.forename: Mehmet A
authors.initials: MA
authors.lastname: Tasyaran
mesh_terms: D000151:Acinetobacter Infections / Q000453:epidemiology; D040981:Acinetobacter baumannii / Q000187:drug effects; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D015780:Carbapenems / Q000627:therapeutic use; D016022:Case-Control Studies; D003091:Colistin / Q000494:pharmacology* / Q000627:therapeutic use; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology*; D006801:Humans; D007709:Klebsiella / Q000187:drug effects; D007710:Klebsiella Infections / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000453:epidemiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects; D015363:Quinolones / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D015363:Quinolones; D003091:Colistin