Mortality in patients with multidrug-resistant Pseudomonas aeruginosa infections: a meta-analysis
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista da Sociedade Brasileira de Medicina Tropical |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822018000400415 |
Resumo: | Abstract Pseudomonas aeruginosa is the leading cause of nosocomial infections with high mortality rates owing to the limited therapeutic options for multidrug-resistant Pseudomonas aeruginosa (MDRPA) and metallo-beta-lactamase (MBL)-producing strains. Herein, we present a meta-analysis exploring the association between MDRPA and São Paulo MBL-1 (SPM-1)-producing strains vs. mortality. Online databases were screened to identify studies published between 2006 and 2016. A total of 15 studies, comprising 3,201 cases of P. aeruginosa infection, were included. Our results demonstrated a higher mortality rate among patients infected with MDRPA (44.6%, 363/813) than those with non-MDRPA infection (24.8%, 593/2,388) [odds ratio (OR) 2.39, 95% confidence interval (CI) 1.70-3.36, p <0.00001]. The risk of mortality in patients with non-SPM-1 strains was four times higher than that observed in the patients of the SPM-1 group; however, no statistically significant difference was observed (p = 0.43). In conclusion, the results of our study demonstrated that patients infected with MDRPA had a significantly higher mortality rate than that of patients infected with non-MDRPA strains, especially patients with bloodstream infection (BSI), immunosuppression, and inadequate antimicrobial therapy. The absence of studies on the molecular aspects of blaSPM-1 and its association with mortality limited the analysis; therefore, our results should be interpreted with caution. Our findings also highlight the need for more studies on the molecular aspects of resistance and the peculiarities of different nosocomial settings. |
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Mortality in patients with multidrug-resistant Pseudomonas aeruginosa infections: a meta-analysisPseudomonas aeruginosaMortalityIntensive care unitBeta-lactamasesNosocomial infectionMeta-analysisAbstract Pseudomonas aeruginosa is the leading cause of nosocomial infections with high mortality rates owing to the limited therapeutic options for multidrug-resistant Pseudomonas aeruginosa (MDRPA) and metallo-beta-lactamase (MBL)-producing strains. Herein, we present a meta-analysis exploring the association between MDRPA and São Paulo MBL-1 (SPM-1)-producing strains vs. mortality. Online databases were screened to identify studies published between 2006 and 2016. A total of 15 studies, comprising 3,201 cases of P. aeruginosa infection, were included. Our results demonstrated a higher mortality rate among patients infected with MDRPA (44.6%, 363/813) than those with non-MDRPA infection (24.8%, 593/2,388) [odds ratio (OR) 2.39, 95% confidence interval (CI) 1.70-3.36, p <0.00001]. The risk of mortality in patients with non-SPM-1 strains was four times higher than that observed in the patients of the SPM-1 group; however, no statistically significant difference was observed (p = 0.43). In conclusion, the results of our study demonstrated that patients infected with MDRPA had a significantly higher mortality rate than that of patients infected with non-MDRPA strains, especially patients with bloodstream infection (BSI), immunosuppression, and inadequate antimicrobial therapy. The absence of studies on the molecular aspects of blaSPM-1 and its association with mortality limited the analysis; therefore, our results should be interpreted with caution. Our findings also highlight the need for more studies on the molecular aspects of resistance and the peculiarities of different nosocomial settings.Sociedade Brasileira de Medicina Tropical - SBMT2018-08-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822018000400415Revista da Sociedade Brasileira de Medicina Tropical v.51 n.4 2018reponame:Revista da Sociedade Brasileira de Medicina Tropicalinstname:Sociedade Brasileira de Medicina Tropical (SBMT)instacron:SBMT10.1590/0037-8682-0506-2017info:eu-repo/semantics/openAccessMatos,Eliseth Costa Oliveira deAndriolo,Regis BruniRodrigues,Yan CorrêaLima,Patrícia Danielle Lima deCarneiro,Irna Carla do Rosário SouzaLima,Karla Valéria Batistaeng2018-08-16T00:00:00Zoai:scielo:S0037-86822018000400415Revistahttps://www.sbmt.org.br/portal/revista/ONGhttps://old.scielo.br/oai/scielo-oai.php||dalmo@rsbmt.uftm.edu.br|| rsbmt@rsbmt.uftm.edu.br1678-98490037-8682opendoar:2018-08-16T00:00Revista da Sociedade Brasileira de Medicina Tropical - Sociedade Brasileira de Medicina Tropical (SBMT)false |
dc.title.none.fl_str_mv |
Mortality in patients with multidrug-resistant Pseudomonas aeruginosa infections: a meta-analysis |
title |
Mortality in patients with multidrug-resistant Pseudomonas aeruginosa infections: a meta-analysis |
spellingShingle |
Mortality in patients with multidrug-resistant Pseudomonas aeruginosa infections: a meta-analysis Matos,Eliseth Costa Oliveira de Pseudomonas aeruginosa Mortality Intensive care unit Beta-lactamases Nosocomial infection Meta-analysis |
title_short |
Mortality in patients with multidrug-resistant Pseudomonas aeruginosa infections: a meta-analysis |
title_full |
Mortality in patients with multidrug-resistant Pseudomonas aeruginosa infections: a meta-analysis |
title_fullStr |
Mortality in patients with multidrug-resistant Pseudomonas aeruginosa infections: a meta-analysis |
title_full_unstemmed |
Mortality in patients with multidrug-resistant Pseudomonas aeruginosa infections: a meta-analysis |
title_sort |
Mortality in patients with multidrug-resistant Pseudomonas aeruginosa infections: a meta-analysis |
author |
Matos,Eliseth Costa Oliveira de |
author_facet |
Matos,Eliseth Costa Oliveira de Andriolo,Regis Bruni Rodrigues,Yan Corrêa Lima,Patrícia Danielle Lima de Carneiro,Irna Carla do Rosário Souza Lima,Karla Valéria Batista |
author_role |
author |
author2 |
Andriolo,Regis Bruni Rodrigues,Yan Corrêa Lima,Patrícia Danielle Lima de Carneiro,Irna Carla do Rosário Souza Lima,Karla Valéria Batista |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Matos,Eliseth Costa Oliveira de Andriolo,Regis Bruni Rodrigues,Yan Corrêa Lima,Patrícia Danielle Lima de Carneiro,Irna Carla do Rosário Souza Lima,Karla Valéria Batista |
dc.subject.por.fl_str_mv |
Pseudomonas aeruginosa Mortality Intensive care unit Beta-lactamases Nosocomial infection Meta-analysis |
topic |
Pseudomonas aeruginosa Mortality Intensive care unit Beta-lactamases Nosocomial infection Meta-analysis |
description |
Abstract Pseudomonas aeruginosa is the leading cause of nosocomial infections with high mortality rates owing to the limited therapeutic options for multidrug-resistant Pseudomonas aeruginosa (MDRPA) and metallo-beta-lactamase (MBL)-producing strains. Herein, we present a meta-analysis exploring the association between MDRPA and São Paulo MBL-1 (SPM-1)-producing strains vs. mortality. Online databases were screened to identify studies published between 2006 and 2016. A total of 15 studies, comprising 3,201 cases of P. aeruginosa infection, were included. Our results demonstrated a higher mortality rate among patients infected with MDRPA (44.6%, 363/813) than those with non-MDRPA infection (24.8%, 593/2,388) [odds ratio (OR) 2.39, 95% confidence interval (CI) 1.70-3.36, p <0.00001]. The risk of mortality in patients with non-SPM-1 strains was four times higher than that observed in the patients of the SPM-1 group; however, no statistically significant difference was observed (p = 0.43). In conclusion, the results of our study demonstrated that patients infected with MDRPA had a significantly higher mortality rate than that of patients infected with non-MDRPA strains, especially patients with bloodstream infection (BSI), immunosuppression, and inadequate antimicrobial therapy. The absence of studies on the molecular aspects of blaSPM-1 and its association with mortality limited the analysis; therefore, our results should be interpreted with caution. Our findings also highlight the need for more studies on the molecular aspects of resistance and the peculiarities of different nosocomial settings. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-08-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822018000400415 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822018000400415 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/0037-8682-0506-2017 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Medicina Tropical - SBMT |
publisher.none.fl_str_mv |
Sociedade Brasileira de Medicina Tropical - SBMT |
dc.source.none.fl_str_mv |
Revista da Sociedade Brasileira de Medicina Tropical v.51 n.4 2018 reponame:Revista da Sociedade Brasileira de Medicina Tropical instname:Sociedade Brasileira de Medicina Tropical (SBMT) instacron:SBMT |
instname_str |
Sociedade Brasileira de Medicina Tropical (SBMT) |
instacron_str |
SBMT |
institution |
SBMT |
reponame_str |
Revista da Sociedade Brasileira de Medicina Tropical |
collection |
Revista da Sociedade Brasileira de Medicina Tropical |
repository.name.fl_str_mv |
Revista da Sociedade Brasileira de Medicina Tropical - Sociedade Brasileira de Medicina Tropical (SBMT) |
repository.mail.fl_str_mv |
||dalmo@rsbmt.uftm.edu.br|| rsbmt@rsbmt.uftm.edu.br |
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1752122161167859712 |