Cargando…

Clinical Response and Outcome in Patients with Multidrug Resistant Gram-negative Infections

OBJECTIVE: In this study, frequency and antimicrobial sensitivity pattern of multidrug resistant (MDR) microorganisms were evaluated in a referral teaching hospital in Iran. METHODS: Patients with MDR Gram-negative pathogens were followed during the course of hospitalization. Demographic data, basel...

Descripción completa

Detalles Bibliográficos
Autores principales: Malekolkottab, Masoume, Shojaei, Lida, Khalili, Hossein, Doomanlou, Mahsa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5348857/
https://www.ncbi.nlm.nih.gov/pubmed/28331866
http://dx.doi.org/10.4103/2279-042X.200990
_version_ 1782514339525165056
author Malekolkottab, Masoume
Shojaei, Lida
Khalili, Hossein
Doomanlou, Mahsa
author_facet Malekolkottab, Masoume
Shojaei, Lida
Khalili, Hossein
Doomanlou, Mahsa
author_sort Malekolkottab, Masoume
collection PubMed
description OBJECTIVE: In this study, frequency and antimicrobial sensitivity pattern of multidrug resistant (MDR) microorganisms were evaluated in a referral teaching hospital in Iran. METHODS: Patients with MDR Gram-negative pathogens were followed during the course of hospitalization. Demographic data, baseline diseases, type of biological sample, isolated microorganism, type of infection, antibiotic regimen before the availability of the culture result and change in the antibiotic regimen following receiving the antibiogram results, response to the treatment regimen, and duration of hospitalization and patient's outcome were considered variables for each recruited patient. FINDINGS: In 71% of the patients, antibiotic regimens were changed according to the antibiogram results. A carbapenem alone or plus amikacin or ciprofloxacin were selected regimens for patients with extended-spectrum beta-lactamase (ESBL) infections. For patients with probable carbapenem-resistant Enterobacteriaceae infections, a carbapenem plus colistin was the most common antibiotic regimen. Clinical response was detected in 54.5% of the patients who were treated based on the antibiogram results. Clinical response was higher in the ESBL producers (ESBL-P) than the non-ESBL-P infections (75% vs. 52%). However, this difference was not significant (P = 0.09). Most nonresponders (80%) had sepsis due to Klebsiella species. Finally, 41.9% of the patients were discharged from the hospital and 58.2% died. CONCLUSION: Same as other countries, infections due MDR microorganisms is increasing in the recent years. This type of resistance caused poor clinical response and high rate mortality in the patients.
format Online
Article
Text
id pubmed-5348857
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Medknow Publications & Media Pvt Ltd
record_format MEDLINE/PubMed
spelling pubmed-53488572017-03-22 Clinical Response and Outcome in Patients with Multidrug Resistant Gram-negative Infections Malekolkottab, Masoume Shojaei, Lida Khalili, Hossein Doomanlou, Mahsa J Res Pharm Pract Clinical Study OBJECTIVE: In this study, frequency and antimicrobial sensitivity pattern of multidrug resistant (MDR) microorganisms were evaluated in a referral teaching hospital in Iran. METHODS: Patients with MDR Gram-negative pathogens were followed during the course of hospitalization. Demographic data, baseline diseases, type of biological sample, isolated microorganism, type of infection, antibiotic regimen before the availability of the culture result and change in the antibiotic regimen following receiving the antibiogram results, response to the treatment regimen, and duration of hospitalization and patient's outcome were considered variables for each recruited patient. FINDINGS: In 71% of the patients, antibiotic regimens were changed according to the antibiogram results. A carbapenem alone or plus amikacin or ciprofloxacin were selected regimens for patients with extended-spectrum beta-lactamase (ESBL) infections. For patients with probable carbapenem-resistant Enterobacteriaceae infections, a carbapenem plus colistin was the most common antibiotic regimen. Clinical response was detected in 54.5% of the patients who were treated based on the antibiogram results. Clinical response was higher in the ESBL producers (ESBL-P) than the non-ESBL-P infections (75% vs. 52%). However, this difference was not significant (P = 0.09). Most nonresponders (80%) had sepsis due to Klebsiella species. Finally, 41.9% of the patients were discharged from the hospital and 58.2% died. CONCLUSION: Same as other countries, infections due MDR microorganisms is increasing in the recent years. This type of resistance caused poor clinical response and high rate mortality in the patients. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5348857/ /pubmed/28331866 http://dx.doi.org/10.4103/2279-042X.200990 Text en Copyright: © 2017 Journal of Research in Pharmacy Practice http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Clinical Study
Malekolkottab, Masoume
Shojaei, Lida
Khalili, Hossein
Doomanlou, Mahsa
Clinical Response and Outcome in Patients with Multidrug Resistant Gram-negative Infections
title Clinical Response and Outcome in Patients with Multidrug Resistant Gram-negative Infections
title_full Clinical Response and Outcome in Patients with Multidrug Resistant Gram-negative Infections
title_fullStr Clinical Response and Outcome in Patients with Multidrug Resistant Gram-negative Infections
title_full_unstemmed Clinical Response and Outcome in Patients with Multidrug Resistant Gram-negative Infections
title_short Clinical Response and Outcome in Patients with Multidrug Resistant Gram-negative Infections
title_sort clinical response and outcome in patients with multidrug resistant gram-negative infections
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5348857/
https://www.ncbi.nlm.nih.gov/pubmed/28331866
http://dx.doi.org/10.4103/2279-042X.200990
work_keys_str_mv AT malekolkottabmasoume clinicalresponseandoutcomeinpatientswithmultidrugresistantgramnegativeinfections
AT shojaeilida clinicalresponseandoutcomeinpatientswithmultidrugresistantgramnegativeinfections
AT khalilihossein clinicalresponseandoutcomeinpatientswithmultidrugresistantgramnegativeinfections
AT doomanloumahsa clinicalresponseandoutcomeinpatientswithmultidrugresistantgramnegativeinfections