Title
Risk factors for multidrug-resistant pathogens in bronchiectasis exacerbations
Date Issued
30 September 2017
Access level
open access
Resource Type
journal article
Author(s)
Menéndez R.
Méndez R.
Polverino E.
Amara-Elori I.
Reyes S.
Sahuquillo-Arce J.M.
Fernández-Barat L.
Alcaraz V.
Torres A.
Institut D' Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS)
Publisher(s)
BioMed Central Ltd.
Abstract
Background: Non-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. Methods: A 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. Results: Two 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. Conclusions: Hospitalization 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.
Volume
17
Issue
1
Language
English
OCDE Knowledge area
Sistema respiratorio Enfermedades infecciosas
Scopus EID
2-s2.0-85030227794
PubMed ID
Source
BMC Infectious Diseases
ISSN of the container
14712334
Sources of information: Directorio de Producción Científica Scopus