Mortality in patients with multidrug-resistant Pseudomonas aeruginosa infections: a meta-analysis
Rev. Soc. Bras. Med. Trop
;
51(4): 415-420, July-Aug. 2018. tab, graf
Article
Dans Anglais
| LILACS
| ID: biblio-957444
ABSTRACT
Abstract Pseudomonas aeruginosa is the leading cause of nosocomial infections with high mortality rates owing to the limited therapeutic options for multidrug-resistant Pseudomonas aeruginosa (MDRPA) and metallo-beta-lactamase (MBL)-producing strains. Herein, we present a meta-analysis exploring the association between MDRPA and São Paulo MBL-1 (SPM-1)-producing strains vs. mortality. Online databases were screened to identify studies published between 2006 and 2016. A total of 15 studies, comprising 3,201 cases of P. aeruginosa infection, were included. Our results demonstrated a higher mortality rate among patients infected with MDRPA (44.6%, 363/813) than those with non-MDRPA infection (24.8%, 593/2,388) [odds ratio (OR) 2.39, 95% confidence interval (CI) 1.70-3.36, p <0.00001]. The risk of mortality in patients with non-SPM-1 strains was four times higher than that observed in the patients of the SPM-1 group; however, no statistically significant difference was observed (p = 0.43). In conclusion, the results of our study demonstrated that patients infected with MDRPA had a significantly higher mortality rate than that of patients infected with non-MDRPA strains, especially patients with bloodstream infection (BSI), immunosuppression, and inadequate antimicrobial therapy. The absence of studies on the molecular aspects of blaSPM-1 and its association with mortality limited the analysis; therefore, our results should be interpreted with caution. Our findings also highlight the need for more studies on the molecular aspects of resistance and the peculiarities of different nosocomial settings.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Pseudomonas aeruginosa
/
Infections à Pseudomonas
/
Infection croisée
/
Multirésistance bactérienne aux médicaments
/
Antibactériens
Type d'étude:
Étude pronostique
/
Revues systématiques évaluées
Limites du sujet:
Humains
langue:
Anglais
Texte intégral:
Rev. Soc. Bras. Med. Trop
Thème du journal:
Médecine tropicale
Année:
2018
Type:
Article
Pays d'affiliation:
Brésil
Institution/Pays d'affiliation:
Universidade do Estado do Pará/BR
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