Association between infections caused by multidrug-resistant gram-negative bacteria and mortality in critically ill patients

• 作者: Christina Routsi Elisabeth Paramythiotou
• 来源期刊: 世界重症医学杂志
• 学科: 医学
• 关键词: Critically ILL patients INFECTIONS MULTIDRUG resistance GRAM-NEGATIVE pathogens MORTALITY
• 年，卷（期）: 2016,（2）
• 页码范围: 111-120
• 页数: 10页
• 分类号: R

摘要

The incidence of gram-negative multidrug-resistant(MDR)bacterial pathogens is increasing in hospitals and particularly in the intensive care unit(ICU)setting.The clinical consequences of infections caused by MDR pathogens remain controversial.The purpose of this review is to summarize the available data concerning the impact of these infections on mortality in ICU patients.Twenty-four studies,conducted exclusively in ICU patients,were identified through PubMed search over the years 2000-2015.Bloodstream infection was the only infection examined in eight studies,respiratory infections in four and variable infections in others.Comparative data on the appropriateness of empirical antibiotic treatment were provided by only seven studies.In ten studies the presence of antimicrobial resistance was not associated with increased mortality;on the contrary,in other studies a significant impact of antibiotic resistance on mortality was found,though,sometimes,mediated by inappropriate antimicrobial treatment.Therefore,a direct association between infections due to gram-negative MDR bacteria and mortality in ICU patients cannot be confirmed.Sample size,presence of multiple confounders and other methodological issues may influence the results.These data support the need for further studies to elucidate the real impact of infections caused by resistant bacteria in ICU patients.