Abstract:
:This study aimed to characterise UTIs caused by Pseudomonas aeruginosa in hospitalised adults and to identify risk factors for infections caused by multidrug-resistant (MDR) strains. A retrospective case-case-control study was conducted in two Italian teaching hospitals. Totally, 242 monomicrobial P. aeruginosa UTIs were analysed; 65 (26.9%) were caused by MDR strains. Clinical treatment failure at 72 h in 215 patients receiving empirical therapy was more frequent in MDR versus non-MDR cases [35/59 (59.3%) vs. 55/156 (35.3%); P = 0.001], particularly when a β-lactam/β-lactamase inhibitor or fluoroquinolone was initially prescribed. By Day 7 (when all regimens were consistent with antimicrobial susceptibility results), treatment failure rates were similar [MDR 15/65 (23.1%) vs. non-MDR 25/177 (14.1%); P = 0.09]. In-hospital mortality rates remained low in both groups [6/65 (9.2%) vs. 22/177 (12.4%); P = 0.49], but median hospital stay for MDR cases was longer (48 vs. 22 days; P ≤ 0.001). Models for predicting MDR and non-MDR P. aeruginosa UTIs displayed good discriminatory power. Presence of ≥3 risk factors for MDR P. aeruginosa UTI was associated with an OR for this outcome of 7.44 (95% CI 3.24-17.57; P < 0.001; specificity 91%, accuracy 75%). The model for predicting non-MDR P. aeruginosa UTI displayed similar accuracy (74%) with a risk factor burden threshold of ≥2 (OR = 7.02, 95% CI 4.61-10.70; P < 0.001). Risk factor assessment can identify UTIs in hospitalised patients likely to be caused by MDR P. aeruginosa, thereby facilitating targeted infection control and timelier effective treatment.
journal_name
Int J Antimicrob Agentsjournal_title
International journal of antimicrobial agentsauthors
Tumbarello M,Raffaelli F,Peghin M,Losito AR,Chirico L,Giuliano G,Spanu T,Sartor A,Fiori B,Bassetti Mdoi
10.1016/j.ijantimicag.2020.105900subject
Has Abstractpub_date
2020-04-01 00:00:00pages
105900issue
4eissn
0924-8579issn
1872-7913pii
S0924-8579(20)30039-Xjournal_volume
55pub_type
杂志文章abstract::In the present study, a real-time PCR protocol was developed for the detection of macrolide resistance determinants and was validated in a nationwide study in Germany covering a total of 236 Streptococcus pyogenes and 241 Streptococcus pneumoniae strains collected from children < or = 16 years of age with community-ac...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2004.02.020
更新日期:2004-07-01 00:00:00
abstract::Therapeutic drug monitoring for critically ill patients receiving piperacillin/tazobactam is described as a useful tool. However, the minimum inhibitory concentration of piperacillin depends on a sufficiently high concentration of tazobactam in case of β-lactamase-producing strains. Therefore, the relationship between...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2016.06.013
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abstract::Dental biofilm harbouring oral bacteria is highly correlated with the progression of dental diseases. Disruption of biofilm formation via anti-adhesion agents is an alternative means to the antibacterial approach. Previous studies have shown that high molecular weight non-dialysable material (NDM) derived from cranber...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2004.10.014
更新日期:2005-03-01 00:00:00
abstract::The frequency of invasive fungal infections (IFIs) has increased over the last decade with the rise in at-risk populations of patients. The morbidity and mortality of IFIs are high and management of these conditions is a great challenge. With the widespread adoption of antifungal prophylaxis, the epidemiology of invas...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章,评审
doi:10.1016/j.ijantimicag.2007.07.019
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abstract::The importance of the amino acid sequence in the C-terminal domain of penicillin-binding protein 5 (PBP5) and the levels of PBP5 expression to ampicillin resistance of Taiwan clinical isolates of Enterococcus faecium were studied. Sequence data revealed the existence of 12 amino acid sequence variants within the C-ter...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2006.07.027
更新日期:2006-12-01 00:00:00
abstract::S fimbrial adhesins (Sfa) represent virulence factors of E. coli wild-type strains causing urinary tract infections and meningitis of the new born. In order to determine the influence of subinhibitory concentration of antibiotics on the expression of the sfa gene cluster, a wild-type strain carrying the lacZ gene, cod...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/0924-8579(93)90060-i
更新日期:1993-01-01 00:00:00
abstract::We evaluated the efficacy of amphotericin B (1.5mg/kg/day), voriconazole (60mg/kg/day) and posaconazole (60mg/kg/day) in a murine model of systemic infection caused by Neoscytalidium dimidiatum. All the treatments were able to prolong survival and to reduce the tissue burden in the spleen and kidneys of infected mice....
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2009.09.028
更新日期:2010-02-01 00:00:00
abstract::The antimicrobial activities of levofloxacin, clarithromycin and KRM-1648 against Mycobacterium tuberculosis (MTB) and Mycobacterium avium complex (MAC) residing in Mono Mac 6 human macrophage-like cells (MM6-Mphis) and A-549 human type II alveolar epithelial cells (A-549 cells) were studied. We measured the antimicro...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/s0924-8579(00)00163-1
更新日期:2000-09-01 00:00:00
abstract::The objective of this study was to better understand the in vitro activity of flomoxef against clinical extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae. A total of 401 ESBL-producing isolates, including 196 Escherichia coli, 124 Klebsiella pneumoniae and 81 Proteus mirabilis, were collected consecuti...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2014.11.012
更新日期:2015-05-01 00:00:00
abstract::Although the vancomycin minimum inhibitory concentration (VMIC) susceptibility breakpoint for Staphylococcus aureus was recently lowered to ≤2 mg/L, it is argued that isolates in the higher levels of the susceptible range may bear adverse clinical outcomes. Clinical outcomes (all-cause mortality and treatment failure)...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ijantimicag.2012.07.023
更新日期:2012-12-01 00:00:00
abstract::Spongistatin 1, a macrocyclic lactone polyether from the marine sponge Hyrtios erecta, was fungicidal for a variety of opportunistic yeasts and filamentous fungi, including strains resistant to amphotericin B, ketoconazole and flucytosine. In broth macrodilution assays, MICs ranged from 0.195 to 12.5 microg/ml, and mi...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/s0924-8579(97)00044-7
更新日期:1997-01-01 00:00:00
abstract::Macrolide monotherapy is currently recommended as first-line treatment of mild-to-moderate community-acquired pneumonia (CAP) in penicillin-intolerant/allergic individuals in the UK. However, resistance rates among the commonest cause, Streptococcus pneumoniae, now exceed 10% in the UK and a review of alternative agen...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章,评审
doi:10.1016/j.ijantimicag.2008.02.003
更新日期:2008-08-01 00:00:00
abstract::Carbapenem-resistant Enterobacterales have become a major public-health issue worldwide. Here we report an outbreak caused by a clonal multidrug-resistant Proteus mirabilis strain producing VIM-4 metallo-β-lactamase (MBL) and TEM-2 β-lactamase in a Greek tertiary-care hospital. From July 2015 to February 2016, 27 imip...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2020.106060
更新日期:2020-08-01 00:00:00
abstract::Carbapenem-resistant Acinetobacter spp. are being increasingly reported worldwide, including in South Korea, where we examined 144 representative isolates collected in a nationwide hospital survey in 2005. Metallo-beta-lactamases were detected in only 19.4% of isolates, none of which were Acinetobacter baumannii, wher...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2008.10.009
更新日期:2009-06-01 00:00:00
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journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2008.04.028
更新日期:2008-11-01 00:00:00
abstract::Staphylococcus aureus is responsible for life-threatening and difficult-to-treat infections worldwide and antimicrobial resistance is an increasing concern. Whilst acquired resistance has been widely studied, little is known of the contributions from chromosomal determinants that upon inactivation may reduce the susce...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2017.08.024
更新日期:2018-01-01 00:00:00
abstract::The aim of this study was to evaluate the susceptibility of 20 clinical isolates of Fusarium spp. to classic antifungals [amphotericin B (AmB), itraconazole (ITR), voriconazole (VRC) and caspofungin (CAS)] and to non-antifungal agents [amiodarone (AMD), doxycycline (DOX) and moxifloxacin (MFX)] by the broth microdilut...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2017.10.017
更新日期:2018-05-01 00:00:00
abstract::The bacterial time-kill curves of azithromycin against four bacterial strains (Streptococcus pneumoniae/penicillin-intermediate, S. pneumoniae/penicillin-sensitive, Haemophilus influenzae and Moraxella catarrhalis) were determined by in vitro infection models. Eighteen different pharmacokinetic/pharmacodynamic models ...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2006.08.049
更新日期:2007-03-01 00:00:00
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journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2014.09.013
更新日期:2015-02-01 00:00:00
abstract::From January through June of 1998, 4579 bloodstream infections (BSI) due to bacterial pathogens were reported from SENTRY hospitals in Canada, the USA and Latin America. Staphylococcus aureus, Escherichia coli, and coagulase-negative staphylococcus (CoNS) were the most common pathogens, together accounting for 55.2% o...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
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更新日期:2000-02-01 00:00:00
abstract::The purpose of this study was to characterise the metallo-beta-lactamase VIM-6 and the genetic environment of the bla(VIM-6) gene. The bla(VIM-6) gene was cloned into an Escherichia coli expression system and the purified VIM-6 enzyme was obtained. VIM-6 has an isoelectric point of 4.9 and a molecular weight of 28.368...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2008.05.017
更新日期:2008-11-01 00:00:00
abstract::In vitro and in vivo anti-Candida albicans and anti-Aspergillus fumigatus activities of NND-502, a new imidazole-antimycotic, were compared with those of fluconazole (FCZ), itraconazole (ITZ) and/or amphotericin B (AmB). NND-502 exhibited strong in vitro antifungal activity against both fungal species; its MIC against...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/s0924-8579(99)00076-x
更新日期:1999-08-01 00:00:00
abstract::No vaccine exists against any form of leishmaniasis. Because recovery from infection is usually accompanied by a strong immunity and because it is possible to protect experimental animals against live challenge, hope for the development of a vaccine for humans has been high. However, leishmaniasis is a disease of the ...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章,评审
doi:10.1016/j.ijantimicag.2010.06.024
更新日期:2010-11-01 00:00:00
abstract::Resistance to antimicrobial agents in Gram-positive and Gram-negative bacteria is common in Turkey. In this review, resistance to several antimicrobial agents in this country is discussed for bacteria which have gained clinical importance in recent years. Among Gram-positives, staphylococci are of major importance bec...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/0924-8579(95)00026-5
更新日期:1995-09-01 00:00:00
abstract::Antimicrobial agents (AMAs) have been used in agriculture since the 1950s as growth-promoting agents [antimicrobial growth promoters (AGPs)]. They have provided benefits to the agricultural industry by increasing production efficiencies and maximising livestock health, yet the potential risks surrounding resistance to...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章,评审
doi:10.1016/j.ijantimicag.2016.08.006
更新日期:2017-01-01 00:00:00
abstract::Antimicrobial stewardship (AMS) is the cornerstone activity in the combat against antimicrobial resistance. In order to ensure sustainable deployment and development of AMS, a strategic and regulatory framework needs to be provided by national healthcare authorities. Experts from 32 European countries, Israel and Turk...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2018.07.019
更新日期:2018-11-01 00:00:00
abstract::Each year, some 25-30 million international travellers from non-tropical regions visit malaria endemic countries. Up to 10,000 cases of malaria are imported into industrialised countries with an average case fatality rate of around 1%. Malaria still poses a real threat to travellers, particularly in areas with high tr...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章,评审
doi:10.1016/s0924-8579(02)00367-9
更新日期:2003-02-01 00:00:00
abstract::We employed an in-vivo pharmacokinetic/in-vitro pharmacodynamic method to simulate bacterial killing in plasma and the interstitium of skeletal muscle tissue after intravenous administration of 2 g of cefpirome and 8 g of fosfomycin alone and in combination to patients with sepsis. Interstitial antimicrobial concentra...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/s0924-8579(03)00047-5
更新日期:2003-06-01 00:00:00
abstract::Many antimicrobial agents including new quinolones (NQs) influence the cellular defense mechanisms such as polymorphonuclear leukocytes (PMNs), macrophages and lymphocytes. We examined the effects of NQs on superoxide (SO) production of PMNs following stimulation of phorbol myristate acetate (PMA). Ofloxacin (OFLX) an...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/0924-8579(95)00024-0
更新日期:1995-12-01 00:00:00
abstract::In this study, the prevalence and characteristics of metallo-β-lactamase (MBL)-producing Pseudomonas aeruginosa isolates in South Korea were investigated. Among 215 P. aeruginosa isolates collected from eight hospitals, 77 (35.8%) and 72 (33.5%) were resistant to imipenem and meropenem, respectively. Of the 77 imipene...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2017.01.023
更新日期:2017-06-01 00:00:00