Importance of Site of Infection and Antibiotic Selection in the Treatment of Carbapenem-Resistant Pseudomonas aeruginosa Sepsis

Antimicrob Agents Chemother. 2018 Mar 27;62(4):e02400-17. doi: 10.1128/AAC.02400-17. Print 2018 Apr.

Abstract

In a retrospective analysis of 215 patients with carbapenem-resistant Pseudomonas aeruginosa sepsis, we observed a significantly higher risk of mortality associated with respiratory tract infection (risk ratio [RR], 1.20; 95% confidence interval [CI], 1.04 to 1.39; P = 0.010) and lower risk with urinary tract infection (RR, 0.80; 95% CI, 0.71 to 0.90; P = 0.004). Aminoglycoside monotherapy was associated with increased mortality, even after adjusting for confounders (adjusted RR, 1.72; 95% CI, 1.03 to 2.85; P = 0.037), consistent across multiple sites of infection.

Keywords: Pseudomonas aeruginosa; carbapenem resistance; multidrug resistance; sepsis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Carbapenems / pharmacology*
  • Carbapenems / therapeutic use
  • Drug Resistance, Multiple, Bacterial
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pseudomonas Infections / drug therapy*
  • Pseudomonas Infections / microbiology
  • Pseudomonas aeruginosa / drug effects*
  • Pseudomonas aeruginosa / pathogenicity
  • Retrospective Studies
  • Sepsis / drug therapy
  • Urinary Tract Infections / drug therapy
  • Urinary Tract Infections / microbiology

Substances

  • Carbapenems