Prevalence of multidrug-resistant Pseudomonas aeruginosa and carbapenem-resistant Enterobacteriaceae among specimens from hospitalized patients with pneumonia and bloodstream infections in the United States from 2000 to 2009.

MedStar author(s):
Citation: Journal of Hospital Medicine (Online). 8(10):559-63, 2013 Oct.PMID: 24022878Institution: MedStar Washington Hospital CenterDepartment: Medicine/Pulmonary-Critical CareForm of publication: Journal ArticleMedline article type(s): Journal Article | Multicenter Study | Research Support, Non-U.S. Gov'tSubject headings: *Carbapenems/tu [Therapeutic Use] | *Cross Infection/dt [Drug Therapy] | *Drug Resistance, Multiple, Bacterial/de [Drug Effects] | *Enterobacteriaceae/de [Drug Effects] | *Pneumonia, Bacterial/dt [Drug Therapy] | *Pseudomonas aeruginosa/de [Drug Effects] | Adult | Aged | Carbapenems/pd [Pharmacology] | Cross Infection/ep [Epidemiology] | Databases, Factual | Drug Resistance, Multiple, Bacterial/ph [Physiology] | Enterobacteriaceae Infections/dt [Drug Therapy] | Enterobacteriaceae Infections/ep [Epidemiology] | Enterobacteriaceae/ip [Isolation & Purification] | Female | Hospitalization/td [Trends] | Humans | Male | Middle Aged | Pneumonia, Bacterial/ep [Epidemiology] | Prevalence | Pseudomonas aeruginosa/ip [Isolation & Purification] | Pseudomonas Infections/dt [Drug Therapy] | Pseudomonas Infections/ep [Epidemiology] | Sepsis/dt [Drug Therapy] | Sepsis/ep [Epidemiology] | United States/ep [Epidemiology] | Young AdultYear: 2013Local holdings: Available in print through MWHC library: 2007 onlyISSN:
  • 1553-5592
Name of journal: Journal of hospital medicine : an official publication of the Society of Hospital MedicineAbstract: BACKGROUND: Antimicrobial resistance complicates antibiotic selection. Pseudomonas aeruginosa (PA), common in pneumonia and blood stream infections (BSIs), is frequently resistant to multiple antimicrobial classes. Carbapenem-resistant Enterobacteriaceae (CRE) have emerged as a pathogen of concern over the past decade.CONCLUSIONS: Although CRE organisms have emerged as an important pathogen in BSI and pneumonia, MDR-PA remains more prevalent in the United States. 2013 Society of Hospital Medicine.DESIGN: Survey of data from a nationally representative sample of microbiology laboratories in 217 hospitals in the United States.METHODS/SETTING: We examined Eurofins' The Surveillance Network database from 2000 to 2009 to explore the proportion of all PA in pneumonia and BSI that is MDR. We performed the same analysis for CRE as a proportion of Enterobacteriaceae. We defined MDR-PA as any isolate resistant to >3 drug classes. Enterobacteriaceae were CRE if resistant to both a third generation cephalosporin and a carbapenem.OBJECTIVE: To determine the prevalence of CRE and multidrug-resistant PA (MDR-PA) in pneumonia and BSI hospitalizations.RESULTS: We identified 205,526 PA (187,343 pneumonia; 18,183 BSI) and 95,566 Enterobacteriaceae specimens (58,810 pneumonia; 36,756 BSI). The prevalence of MDR-PA was ~15-fold higher than CRE in both infection types (pneumonia: 22.0% MDR-PA vs 1.6% CRE; BSI: 14.7% MDR-PA vs 1.1% CRE). There was a net rise in MDR-PA as a proportion of all PA from 2000 to 2009 (BSI: 10.7%-13.5%; pneumonia: 19.2%-21.7%). The CRE phenotype emerged in 2002 in both infection types, peaking in 2008 at 3.6% in BSI and 5.3% in pneumonia, and stabilized thereafter.All authors: Shorr AF, Zilberberg MDFiscal year: FY2014Digital Object Identifier: Date added to catalog: 2014-08-21
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 24022878 Available 24022878

Available in print through MWHC library: 2007 only

BACKGROUND: Antimicrobial resistance complicates antibiotic selection. Pseudomonas aeruginosa (PA), common in pneumonia and blood stream infections (BSIs), is frequently resistant to multiple antimicrobial classes. Carbapenem-resistant Enterobacteriaceae (CRE) have emerged as a pathogen of concern over the past decade.

CONCLUSIONS: Although CRE organisms have emerged as an important pathogen in BSI and pneumonia, MDR-PA remains more prevalent in the United States. 2013 Society of Hospital Medicine.

DESIGN: Survey of data from a nationally representative sample of microbiology laboratories in 217 hospitals in the United States.

METHODS/SETTING: We examined Eurofins' The Surveillance Network database from 2000 to 2009 to explore the proportion of all PA in pneumonia and BSI that is MDR. We performed the same analysis for CRE as a proportion of Enterobacteriaceae. We defined MDR-PA as any isolate resistant to >3 drug classes. Enterobacteriaceae were CRE if resistant to both a third generation cephalosporin and a carbapenem.

OBJECTIVE: To determine the prevalence of CRE and multidrug-resistant PA (MDR-PA) in pneumonia and BSI hospitalizations.

RESULTS: We identified 205,526 PA (187,343 pneumonia; 18,183 BSI) and 95,566 Enterobacteriaceae specimens (58,810 pneumonia; 36,756 BSI). The prevalence of MDR-PA was ~15-fold higher than CRE in both infection types (pneumonia: 22.0% MDR-PA vs 1.6% CRE; BSI: 14.7% MDR-PA vs 1.1% CRE). There was a net rise in MDR-PA as a proportion of all PA from 2000 to 2009 (BSI: 10.7%-13.5%; pneumonia: 19.2%-21.7%). The CRE phenotype emerged in 2002 in both infection types, peaking in 2008 at 3.6% in BSI and 5.3% in pneumonia, and stabilized thereafter.

English

Powered by Koha