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ANTIMICROBIAL AGENTS AND RESISTANCE |
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Kocaeli Universitesi, Tip Fakultesi, Klinik Bakteriyoloji and Infeksiyon Hastaliklari AD, Kocaeli, *Cerrahpa
a Tip Fakültesi, Mikrobiyoloji AD, Istanbul, KTÜ Tip Fakültesi, Klinik Bakteriyoloji and Infeksiyon Hastaliklari AD, Trabzon, Florence Nightingale Hastanesi, Klinik Mikrobiyoloji Lab, Istanbul, Trakya Üniversitesi Tip Fakültesi, Klinik Bakteriyoloji and Infeksiyon Hastaliklari AD, Edirne, ||Ondokuz Mayis Üniversitesi, Tip Fakültesi, Klinik Bakteriyoloji and Infeksiyon Hastaliklari AD, Samsun, **Ege Universitesi Tip Fakültesi, Klinik Bakteriyoloji and Infeksiyon Hastaliklari AD, I·zmir, Uludag Universitesi Tip Fakültesi, Klinik Bakteriyoloji and Infeksiyon Hastaliklari AD, Bursa, Hacettepe Universitesi Tip Fakültesi, Infeksiyon Hastaliklari Birimi, Ankara and Marmara Universitesi Tip Fakültesi, Infeksiyon Hastaliklari Birimi, Istanbul, Turkey
Corresponding author: Dr H. Vahaboglu (e-mail: vahabo{at}hotmail.com).
Received 30 May 2000; revised version received 27 Sept. 2000; accepted 19 Dec. 2000.
Abstract
Recently, an extended-spectrum ß-lactamase (PER-1) was found to be disseminated among Acinetobacter spp. and Pseudomonas aeruginosa isolates in Turkey. A population-based cohort study was conducted to elucidate predictive mortality factors in patients with nosocomial infections caused by Acinetobacter spp. and P. aeruginosa, with particular reference to PER-1-type extended-spectrum ß-lactamase (ESBL) production. The study group comprised 16 and 21 non-survivors and 82 and 126 survivors in cohorts infected with Acinetobacter and P. aeruginosa, respectively. In the Acinetobacter-infected cohort, nosocomial pneumonia, hypotension and infection with a PER-positive isolate were independent predictors of mortality. In the P. aeruginosa-infected cohort, impaired consciousness, a PER-positive isolate, male sex and (with a negative relative risk) urinary tract infection were independent predictors of death. This study demonstrated the relationship of PER-1-type ESBL-producing Acinetobacter spp. and P. aeruginosa with poor clinical outcome.
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