Acquisition of extensive drug-resistant Pseudomonas aeruginosa among hospitalized patients

Risk factors and resistance mechanisms to carbapenems

Y. S. Park, H. Lee, B. S. Chin, S. H. Han, S. G. Hong, S. K. Hong, H. Y. Kim, Y. Uh, H. B. Shin, E. J. Choo, S. H. Han, W. Song, Seokhoon Jeong, Kyungwon Lee, J. M. Kim

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Extensive drug-resistant Pseudomonas aeruginosa (XDRPA) strains, defined as resistant to all available antipseudomonal antibiotics, have been reported recently. This study aimed to investigate the risk factors for XDRPA acquisition by patients and the resistance mechanisms to carbapenems. From June to November 2007, XDRPA isolates were collected from patients in eight tertiary care hospitals. A case-control study was performed to determine factors associated with XDRPA acquisition. EDTA-imipenem disc synergy tests, and polymerase chain reaction amplification and sequencing were performed to detect the presence of metallo-β-lactamases (MBLs). Risk factor analysis was performed for 33 patients. Mechanical ventilation [odds ratio (OR) 8.2, 95% confidence interval (CI) 1.3-52.2; P=0.026] and APACHE II score (OR 1.2, 95% CI 1.0-1.3; P=0.007) were identified as independent risk factors for XDRPA acquisition. Pulsed-field gel electrophoresis of XDRPA identified clonal epidemic isolates co-existing with sporadic isolates. Eight of 43 (19%) XDRPA isolates were shown to produce MBLs; four produced VIM-2 and four produced IMP-6. This study suggests a major role for mechanical ventilation in XDRPA acquisition. Moreover, pulsed-field gel electrophoresis identified a clonal epidemic within hospitals. Taken together, these results suggest that patient-to-patient transmission contributes to XDRPA acquisition in Korea.

Original languageEnglish
Pages (from-to)54-58
Number of pages5
JournalJournal of Hospital Infection
Volume79
Issue number1
DOIs
Publication statusPublished - 2011 Sep 1

Fingerprint

Carbapenems
Pseudomonas aeruginosa
Pharmaceutical Preparations
Pulsed Field Gel Electrophoresis
Artificial Respiration
Odds Ratio
Confidence Intervals
Inosine Monophosphate
APACHE
Imipenem
Tertiary Healthcare
Korea
Tertiary Care Centers
Edetic Acid
Statistical Factor Analysis
Case-Control Studies
Anti-Bacterial Agents
Polymerase Chain Reaction

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Park, Y. S. ; Lee, H. ; Chin, B. S. ; Han, S. H. ; Hong, S. G. ; Hong, S. K. ; Kim, H. Y. ; Uh, Y. ; Shin, H. B. ; Choo, E. J. ; Han, S. H. ; Song, W. ; Jeong, Seokhoon ; Lee, Kyungwon ; Kim, J. M. / Acquisition of extensive drug-resistant Pseudomonas aeruginosa among hospitalized patients : Risk factors and resistance mechanisms to carbapenems. In: Journal of Hospital Infection. 2011 ; Vol. 79, No. 1. pp. 54-58.
@article{4d0f512a874c4b2090b2eebf03156370,
title = "Acquisition of extensive drug-resistant Pseudomonas aeruginosa among hospitalized patients: Risk factors and resistance mechanisms to carbapenems",
abstract = "Extensive drug-resistant Pseudomonas aeruginosa (XDRPA) strains, defined as resistant to all available antipseudomonal antibiotics, have been reported recently. This study aimed to investigate the risk factors for XDRPA acquisition by patients and the resistance mechanisms to carbapenems. From June to November 2007, XDRPA isolates were collected from patients in eight tertiary care hospitals. A case-control study was performed to determine factors associated with XDRPA acquisition. EDTA-imipenem disc synergy tests, and polymerase chain reaction amplification and sequencing were performed to detect the presence of metallo-β-lactamases (MBLs). Risk factor analysis was performed for 33 patients. Mechanical ventilation [odds ratio (OR) 8.2, 95{\%} confidence interval (CI) 1.3-52.2; P=0.026] and APACHE II score (OR 1.2, 95{\%} CI 1.0-1.3; P=0.007) were identified as independent risk factors for XDRPA acquisition. Pulsed-field gel electrophoresis of XDRPA identified clonal epidemic isolates co-existing with sporadic isolates. Eight of 43 (19{\%}) XDRPA isolates were shown to produce MBLs; four produced VIM-2 and four produced IMP-6. This study suggests a major role for mechanical ventilation in XDRPA acquisition. Moreover, pulsed-field gel electrophoresis identified a clonal epidemic within hospitals. Taken together, these results suggest that patient-to-patient transmission contributes to XDRPA acquisition in Korea.",
author = "Park, {Y. S.} and H. Lee and Chin, {B. S.} and Han, {S. H.} and Hong, {S. G.} and Hong, {S. K.} and Kim, {H. Y.} and Y. Uh and Shin, {H. B.} and Choo, {E. J.} and Han, {S. H.} and W. Song and Seokhoon Jeong and Kyungwon Lee and Kim, {J. M.}",
year = "2011",
month = "9",
day = "1",
doi = "10.1016/j.jhin.2011.05.014",
language = "English",
volume = "79",
pages = "54--58",
journal = "Journal of Hospital Infection",
issn = "0195-6701",
publisher = "W.B. Saunders Ltd",
number = "1",

}

Park, YS, Lee, H, Chin, BS, Han, SH, Hong, SG, Hong, SK, Kim, HY, Uh, Y, Shin, HB, Choo, EJ, Han, SH, Song, W, Jeong, S, Lee, K & Kim, JM 2011, 'Acquisition of extensive drug-resistant Pseudomonas aeruginosa among hospitalized patients: Risk factors and resistance mechanisms to carbapenems', Journal of Hospital Infection, vol. 79, no. 1, pp. 54-58. https://doi.org/10.1016/j.jhin.2011.05.014

Acquisition of extensive drug-resistant Pseudomonas aeruginosa among hospitalized patients : Risk factors and resistance mechanisms to carbapenems. / Park, Y. S.; Lee, H.; Chin, B. S.; Han, S. H.; Hong, S. G.; Hong, S. K.; Kim, H. Y.; Uh, Y.; Shin, H. B.; Choo, E. J.; Han, S. H.; Song, W.; Jeong, Seokhoon; Lee, Kyungwon; Kim, J. M.

In: Journal of Hospital Infection, Vol. 79, No. 1, 01.09.2011, p. 54-58.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Acquisition of extensive drug-resistant Pseudomonas aeruginosa among hospitalized patients

T2 - Risk factors and resistance mechanisms to carbapenems

AU - Park, Y. S.

AU - Lee, H.

AU - Chin, B. S.

AU - Han, S. H.

AU - Hong, S. G.

AU - Hong, S. K.

AU - Kim, H. Y.

AU - Uh, Y.

AU - Shin, H. B.

AU - Choo, E. J.

AU - Han, S. H.

AU - Song, W.

AU - Jeong, Seokhoon

AU - Lee, Kyungwon

AU - Kim, J. M.

PY - 2011/9/1

Y1 - 2011/9/1

N2 - Extensive drug-resistant Pseudomonas aeruginosa (XDRPA) strains, defined as resistant to all available antipseudomonal antibiotics, have been reported recently. This study aimed to investigate the risk factors for XDRPA acquisition by patients and the resistance mechanisms to carbapenems. From June to November 2007, XDRPA isolates were collected from patients in eight tertiary care hospitals. A case-control study was performed to determine factors associated with XDRPA acquisition. EDTA-imipenem disc synergy tests, and polymerase chain reaction amplification and sequencing were performed to detect the presence of metallo-β-lactamases (MBLs). Risk factor analysis was performed for 33 patients. Mechanical ventilation [odds ratio (OR) 8.2, 95% confidence interval (CI) 1.3-52.2; P=0.026] and APACHE II score (OR 1.2, 95% CI 1.0-1.3; P=0.007) were identified as independent risk factors for XDRPA acquisition. Pulsed-field gel electrophoresis of XDRPA identified clonal epidemic isolates co-existing with sporadic isolates. Eight of 43 (19%) XDRPA isolates were shown to produce MBLs; four produced VIM-2 and four produced IMP-6. This study suggests a major role for mechanical ventilation in XDRPA acquisition. Moreover, pulsed-field gel electrophoresis identified a clonal epidemic within hospitals. Taken together, these results suggest that patient-to-patient transmission contributes to XDRPA acquisition in Korea.

AB - Extensive drug-resistant Pseudomonas aeruginosa (XDRPA) strains, defined as resistant to all available antipseudomonal antibiotics, have been reported recently. This study aimed to investigate the risk factors for XDRPA acquisition by patients and the resistance mechanisms to carbapenems. From June to November 2007, XDRPA isolates were collected from patients in eight tertiary care hospitals. A case-control study was performed to determine factors associated with XDRPA acquisition. EDTA-imipenem disc synergy tests, and polymerase chain reaction amplification and sequencing were performed to detect the presence of metallo-β-lactamases (MBLs). Risk factor analysis was performed for 33 patients. Mechanical ventilation [odds ratio (OR) 8.2, 95% confidence interval (CI) 1.3-52.2; P=0.026] and APACHE II score (OR 1.2, 95% CI 1.0-1.3; P=0.007) were identified as independent risk factors for XDRPA acquisition. Pulsed-field gel electrophoresis of XDRPA identified clonal epidemic isolates co-existing with sporadic isolates. Eight of 43 (19%) XDRPA isolates were shown to produce MBLs; four produced VIM-2 and four produced IMP-6. This study suggests a major role for mechanical ventilation in XDRPA acquisition. Moreover, pulsed-field gel electrophoresis identified a clonal epidemic within hospitals. Taken together, these results suggest that patient-to-patient transmission contributes to XDRPA acquisition in Korea.

UR - http://www.scopus.com/inward/record.url?scp=80051471695&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80051471695&partnerID=8YFLogxK

U2 - 10.1016/j.jhin.2011.05.014

DO - 10.1016/j.jhin.2011.05.014

M3 - Article

VL - 79

SP - 54

EP - 58

JO - Journal of Hospital Infection

JF - Journal of Hospital Infection

SN - 0195-6701

IS - 1

ER -