Rapid emergence of colistin resistance and its impact on fatality among healthcare-associated infections

• Published in: The Journal of hospital infection 2018-03, Vol.98 (3), p.260-263
• Main Authors: Aydın, M., Ergönül, Ö., Azap, A., Bilgin, H., Aydın, G., Çavuş, S.A., Demiroğlu, Y.Z., Alışkan, H.E., Memikoğlu, O., Menekşe, Ş., Kaya, Ş., Demir, N.A., Karaoğlan, İ., Başaran, S., Hatipoğlu, Ç., Erdinç, Ş., Yılmaz, E., Tümtürk, A., Tezer, Y., Demirkaya, H., Çakar, Ş.E., Keske, Ş., Tekin, S., Yardımcı, C., Karakoç, Ç., Ergen, P., Azap, Ö., Mülazımoğlu, L., Ural, O., Can, F., Akalın, H.
• Format: Article
• Language: English
• Subjects: Bloodstream; Colistin MIC; Gram-negative; Health care
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/j.jhin.2017.11.014

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.