Resistenzentwicklung von Pseudomonas aeruginosa unter parenteraler antibiotischer Therapie - Einfluss verschiedener Therapieregime und Kostenanalyse
Auch gedruckt in der BibliothekZ: J-H 11.979; W: W-H 11.461
Bröse, Anja Kathrin
Ressourcen- / MedientypDissertation, Text
Datum der Freischaltung2008-09-15
Development of resistance with Pseudomonas aeruginosa during parenteral antibiotic therapy - influence of different antibiotic agents and cost analysis. Background. P. aeruginosa is a leading cause of nosocomial infections and antimicrobial resistance is an emerging problem with it. The aim of our study was to determine risk factors for the emergence of resistant P. aeruginosa among hospitalized patients. Furthermore we studied the effect of treatment with different antipseudomonal agents on the emergence of antimicrobial resistance and the difference between resistant and non-resistant P. aeruginosa concerning costs. Methods. During 22 months we surveyed 90 ICU patients with P. aeruginosa infection. From those patients all P. aeruginosa isolates were collected. Data about demographic characteristics and antibiotic treatment were recorded with a standardized form. Antimicrobial susceptibility was determined according to the recommendations of the Clinical and Laboratory Standards Institute (CLSI). Isolates were considered susceptible, intermediate or resistant according to the criteria of the CLSI. Results and conclusions. Significant risk factors (p<0,05) for emergence of resistance were: common room with a patient who was already infected by P. aeruginosa, length of mechanical ventilation, catecholamine therapy and hemodialysis. There existed a development of resistance under therapy with each of the studied antibiotics, but we could not determine one of the agents as a particular trigger for resistance. Combination of certain antibiotics seemed to be more effective against P. aeruginosa than therapy with those agents alone but has to be strictly considered because of increased toxicity. A greater amount of microbiological cultures, prolongated stay on ICU and longer length of antibiotic treatment were associated with the emergence of resistant P. aeruginosa which leaded to significant higher costs.
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