Risk factors for multidrug-resistant pathogens in bronchiectasis exacerbations

BMC Infectious Diseases

Research Article

Edmundo Rosales-Mayor¹  Eva Polverino²  José Miguel Sahuquillo-Arce³  Victoria Alcaraz⁴  Antoni Torres⁴  Laia Fernández-Barat⁴  Raúl Méndez⁵  Isabel Amara-Elori⁵  Soledad Reyes⁵  Rosario Menéndez⁶ 

[1] Fundació Clínic, Institut D’ Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain;Fundació Clínic, Institut D’ Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain;Centro de Investigación Biomédica En Red-Enfermedades Respiratorias (CIBERES, CB06/06/0028), Madrid, Spain;Microbiology Department, Hospital Universitario y Politécnico La Fe / Instituto de Investigación Sanitaria (IIS) La Fe, Valencia, Spain;Pneumology Department, Hospital Clínico y Provincial, Universidad de Barcelona, Institut D’ Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain;Centro de Investigación Biomédica En Red-Enfermedades Respiratorias (CIBERES, CB06/06/0028), Madrid, Spain;Pneumology Department, Hospital Universitario y Politécnico La Fe / Instituto de Investigación Sanitaria (IIS) La Fe, Universidad de Valencia, Valencia, Spain;Pneumology Department, Hospital Universitario y Politécnico La Fe / Instituto de Investigación Sanitaria (IIS) La Fe, Universidad de Valencia, Valencia, Spain;Centro de Investigación Biomédica En Red-Enfermedades Respiratorias (CIBERES, CB06/06/0028), Madrid, Spain;

关键词: Multidrug-resistant;    Pseudomonas;    Hospitalization;   

DOI  :  10.1186/s12879-017-2754-5

 received in 2017-05-09, accepted in 2017-09-21,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundNon-cystic fibrosis bronchiectasis is a chronic structural lung condition that courses with recurrent infectious exacerbations that lead to frequent antibiotic treatment making this population more susceptible to acquire pathogens with antibiotic resistance. We aimed to investigate risk factors associated with isolation of multidrug-resistant pathogens in bronchiectasis exacerbations.MethodsA prospective observational study was conducted in two tertiary-care hospitals, enrolling patients when first exacerbation appeared. Multidrug-resistance was determined according to European Centre of Diseases Prevention and Control classification.ResultsTwo hundred thirty three exacerbations were included and microorganisms were isolated in 159 episodes. Multidrug-resistant pathogens were found in 20.1% episodes: Pseudomonas aeruginosa (48.5%), methicillin-resistant Staphylococcus aureus (18.2%) and Extended spectrum betalactamase + Enterobacteriaceae (6.1%), and they were more frequent in exacerbations requiring hospitalization (24.5% vs. 10.2%, p: 0.016). Three independent multidrug-resistant risk factors were found: chronic renal disease (Odds ratio (OR), 7.60, 95% CI 1.92–30.09), hospitalization in the previous year (OR, 3.88 95% CI 1.37–11.02) and prior multidrug-resistant isolation (OR, 5.58, 95% CI 2.02–15.46). The proportion of multidrug-resistant in the 233 exacerbations was as follows: 3.9% in patients without risk factors, 12.6% in those with 1 factor and 53.6% if ≥2 risk factors.ConclusionsHospitalization in the previous year, chronic renal disease, and prior multidrug-resistant isolation are risk factors for identification multidrug-resistant pathogens in exacerbations. This information may assist clinicians in choosing empirical antibiotics in daily clinical practice.

【 授权许可】

CC BY   
© The Author(s). 2017