國家衛生研究院 NHRI:Item 3990099045/8793
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    題名: Risk factors and outcome for colistin resistant acinetobacter nosocomialis bacteraemia in patients without previous colistin exposure
    作者: Wang, YC;Lee, YT;Yang, YS;Chen, CT;Chiu, CH;Yin, T;Kuo, SC;Chen, TL;Lin, JC;Wang, F;Fung, CP;Chang, FY
    貢獻者: Division of Infectious Diseases
    摘要: The clinical characteristics of patients with colistin-resistant A. baumannii have been documented, but those of other Acinetobacter species remain unknown. Previous exposure of colistin has been documented to be associated with the emergence of colistin resistance, but may be not the only predisposing factor. In the current study, we highlight the risk and outcome of patients without previous exposure to colistin who acquired colistin-resistant Acinetobacter nosocomialis (ColRAN) bacteraemia. This 11-year single-center retrospective study analyzed 58 patients with ColRAN bacteraemia and 213 patients with colistin-susceptible A. nosocomialis (ColSAN) bacteraemia. Antimicrobial susceptibilities were determined by an agar dilution method. The clonal relationship of ColRAN isolates was determined by pulse-field gel electrophoresis. A conjugation mating-out assay was conducted to delineate potential transfer of colistin resistance genes. Multivariable analysis was performed to evaluate the risk factors for ColRAN bacteraemia. Chronic obstructive pulmonary disease (COPD) was independently associated with ColRAN bacteraemia (odds ratio, 3.04; 95% confidence interval, 1.45-6.37, p 0.003). Patients with ColRAN had higher APACHE II scores, but the two groups had no significant differences in 14-day (10.3% vs. 10.3%) or 28-day mortality (15.5% vs. 15.0%). ColRAN isolates had greater resistance to most antimicrobial agents than ColSAN, except ciprofloxacin (0% vs. 6.6%). There were 16 different ColRAN pulsotypes and two major clones were found. Colistin resistance did not transfer to colistin-susceptible A. baumannii or A. nosocomialis. These results highlighted COPD is an independent risk factor for acquisition of ColRAN bacteraemia. The mortality rates were similar between patients with ColRAN and ColSAN bacteraemia.
    日期: 2015-08
    關聯: Clinical Microbiology and Infection. 2015 Aug;21(8):758-764.
    Link to: http://dx.doi.org/10.1016/j.cmi.2015.05.005
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=1198-743X&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000358269200008
    Cited Times(Scopus): http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84937521995
    顯示於類別:[郭書辰] 期刊論文

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