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Rapid emergence of colistin resistance and its impact on fatality among healthcare-associated infections
(W B Saunders Co Ltd, 2018) Aydın, M.; Ergönül, O.; Azap, A.; Bilgin, H.; Aydın, G.; Çavuş, S. A.; Demiroğlu, Y. Z.; Alışkan, H. E.; Memikoğlu, O.; Menekşe, S.; Kaya, S.; Demir, N. A.; Karaoğlan, I.; Başaran, S.; Hatipoğlu, C.; Erdinç, S.; Yılmaz, E.; Tümtürk, A.; Tezer, Y.; Demirkaya, H.; Çakar, S. E.; Keşke, S.; Tekin, S.; Yardımcı, C.; Karakoç, Zehra Çağla; Ergen, P.; Azap, O.; Mülazimoğlu, L.; Ural, O.; Can, F.; Akalın, H.
This article describes the emergence of resistance and predictors of fatality for 1556 cases of healthcare-associated Gram-negative bloodstream infection in 2014 and 2015. The colistin resistance rate in Klebsiella pneumoniae was 16.1%, compared with 6% in 2013. In total, 660 (42.4%) cases were fatal. The highest fatality rate was among patients with Acinetobacter baumannii bacteraemia (58%), followed by Pseudomonas aeruginosa (45%), Klebsiella pneumoniae (41%), Enterobacter cloacae (32%) and Escherichia coli (28%). On multi-variate analysis, the minimum inhibitory concentrations for carbapenems [odds ratio (OR) 1.02, 95% confidence interval (CI) 1.01-1.04; P = 0.002] and colistin (OR 1.1, 95% CI 1.03-1.17; P = 0.001) were found to be significantly associated with fatality. (C) 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.