期刊
JOURNAL OF INFECTIOUS DISEASES
卷 192, 期 9, 页码 1606-1612出版社
OXFORD UNIV PRESS INC
DOI: 10.1086/444469
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Background. A study was conducted in the Calgary Health Region between May 2002 and April 2004 to define the population-based epidemiological characteristics of infections caused by imipenem-resistant Pseudomonas aeruginosa and to explore the clinical outcomes due to metallo-beta-lactamase (MBL) - producing and non - MBL-producing strains. Methods. Detailed clinical information was obtained by chart review, and phenotypic and molecular characterizations were performed using the MBL E-test, polymerase chain reaction with sequencing, and pulsed-field gel electrophoresis. Results. A total of 228 patients with infections caused by imipenem-resistant P. aeruginosa were identified ( annual incidence, 10.5 cases/100,000 population), with the highest incidence rate in those >= 75 years old. MBL-producing strains (98/228) were associated with higher rates of multidrug resistance and bacteremia. Ninety MBL-producing strains also produced VIM-2, 4 produced IMP-7, and 4 were unclassified. A cluster of VIM-2 - producing strains was responsible for a nosocomial outbreak during 2003. The case-fatality rate was significantly higher for infections caused by MBL-producing strains than for those caused by non - MBL-producing strains (25% vs. 13%; relative risk, 1.98 [95% confidence interval, 1.00 - 3.90]; P = .05). Conclusion. MBL-producing P. aeruginosa strains were associated with a higher case-fatality rate and invasive disease. Our study highlights the potential importance of molecular laboratory techniques in infection control and patient care.
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