Mortality in patients with multidrug-resistant Pseudomonas aeruginosa infections: a meta-analysis
Matos, Eliseth Costa Oliveira de
Andriolo, Regis Bruni
Rodrigues, Yan Corrêa
Lima, Patrícia Danielle Lima de
Carneiro, Irna Carla do Rosário Souza
Lima, Karla Valéria Batista
Pseudomonas aeruginosa is the leading cause of nosocomial infections with high mortality rates owing to the limited therapeutic options for multidrug-resistant Pseudomonas aeruginosa (MDRPA) and metallo-beta-lactamase (MBL)-producing strains. Herein, we present a meta-analysis exploring the association between MDRPA and São Paulo MBL-1 (SPM-1)-producing strains vs. mortality. Online databases were screened to identify studies published between 2006 and 2016. A total of 15 studies, comprising 3,201 cases of P. aeruginosa infection, were included. Our results demonstrated a higher mortality rate among patients infected with MDRPA (44.6%, 363/813) than those with non-MDRPA infection (24.8%, 593/2,388) [odds ratio (OR) 2.39, 95% confidence interval (CI) 1.70-3.36, p <0.00001]. The risk of mortality in patients with non-SPM-1 strains was four times higher than that observed in the patients of the SPM-1 group; however, no statistically significant difference was observed (p = 0.43). In conclusion, the results of our study demonstrated that patients infected with MDRPA had a significantly higher mortality rate than that of patients infected with non-MDRPA strains, especially patients with bloodstream infection (BSI), immunosuppression, and inadequate antimicrobial therapy. The absence of studies on the molecular aspects of blaSPM-1 and its association with mortality limited the analysis; therefore, our results should be interpreted with caution. Our findings also highlight the need for more studies on the molecular aspects of resistance and the peculiarities of different nosocomial settings.
xmlui.dri2xhtml.METS-1.0.item-citationMATOS, Eliseth Costa Oliveira de et al. Mortality in patients with multidrug-resistant Pseudomonas aeruginosa infections: a meta-analysis. Revista da Sociedade Brasileira de Medicina Tropical, v. 51, n. 4, p. 415-420, July-August, 2018.
xmlui.dri2xhtml.METS-1.0.item-decsPrimaryPseudomonas aeruginosa / patogenicidade
Infecções por Pseudomonas
Infecção Hospitalar / mortalidade
Unidades de Terapia Intensiva / estatística & dados numéricos
Resistência Microbiana a Medicamentos