ArticleAntimicrobial agents and chemotherapy2014
Antibiotic pressure is a major risk factor for rectal colonization by multidrug-resistant Pseudomonas aeruginosa in critically ill patients.
Article in Antimicrobial agents and chemotherapy, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
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Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Gut colonization with multidrug resistant organisms in the intensive care unit: a systematic review and meta-analysis.Critical care (London, England) · 2024Pooled it
- Risk factors for hospitalized patients with resistant or multidrug-resistantAntimicrobial resistance and infection control · 2018Pooled it
- Multidrug resistant Pseudomonas aeruginosa in Estonian hospitals.BMC infectious diseases · 2018Trial
- Beyond Colonization: Dynamic Risk Stratification and Clinical Decision-Making for MDR Gram-Negative Infections in Critically Ill Patients.Biomedicines · 2026Review
- Pseudomonas aeruginosa carriage and associated risk factors in healthy individuals and patients from Rotterdam, Rome, and Jakarta.Scientific reports · 2025Article
- Article
- The emerging role ofGerms · 2024Review
- Extensively drug-resistantFrontiers in microbiology · 2024Article
- Age of Antibiotic Resistance in MDR/XDR Clinical Pathogen ofPharmaceuticals (Basel, Switzerland) · 2023Review
- Gut to lung translocation and antibiotic mediated selection shape the dynamics of Pseudomonas aeruginosa in an ICU patient.Nature communications · 2022Article
- Review
- Risk Factors for Multidrug-Resistant Gram-Negative Bacteria Carriage upon Admission to the Intensive Care Unit.International journal of environmental research and public health · 2022Article
- A Large Multicenter Prospective Study of Community-Onset Healthcare Associated Bacteremic Urinary Tract Infections in the Era of Multidrug Resistance: Even Worse than Hospital Acquired Infections?Infectious diseases and therapy · 2021Article
- Epidemiology and Treatment of Multidrug-Resistant and Extensively Drug-Resistant Pseudomonas aeruginosa Infections.Clinical microbiology reviews · 2019Review
- Article
- Influence of antibiotic pressure on multi-drug resistantAntimicrobial resistance and infection control · 2019Observational
- Risk factors and the resistance mechanisms involved inJournal of intensive care · 2019Article
- Poultry and beef meat as potential seedbeds for antimicrobial resistant enterotoxigenic Bacillus species: a materializing epidemiological and potential severe health hazard.Scientific reports · 2018Article
- Recent Anti-Microbial Exposure Is Associated with More Complications after Elective Surgery.Surgical infections · 2018Article
- A prospective surveillance study for multidrug-resistant bacteria colonization in hospitalized patients at a Thai University Hospital.Antimicrobial resistance and infection control · 2018Article
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8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
The intestinal reservoir is central to the epidemiology of Pseudomonas aeruginosa, but the dynamics of intestinal colonization by different phenotypes have been poorly described. To determine the impact of antimicrobial exposure on intestinal colonization by multidrug-resistant (MDR) and extensively drug-resistant (XDR) P. aeruginosa, we screened intensive care unit (ICU) patients for rectal colonization on admission and at weekly intervals. During an 18-month study period, 414 ICU patients were enrolled, of whom 179 (43%) were colonized; 112 (63%) of these were identified at ICU admission and 67 (37%) during their ICU stay. At 10 days after ICU admission, the probabilities of carriage were 44%, 24%, and 24% for non-MDR, MDR-non-XDR, and XDR P. aeruginosa strains, respectively (log rank, 0.02). Pulsed-field gel electrophoresis showed 10 pairs of non-MDR P. aeruginosa and subsequent MDR-non-XDR strains isolated from the same patients to be clonally identical and another 13 pairs (8 MDR-non-XDR and 5 XDR) to be unrelated. There was one specific clone between the 8 MDR-non-XDR strains and an identical genotype in the 5 XDR isolates. The Cox regression analysis identified MDR P. aeruginosa acquisition as associated with the underlying disease severity (adjusted hazard ratio [aHR], 1.97; 95% confidence interval [CI], 1.22 to 3.18; P = 0.006) and prior use of fluoroquinolones (aHR, 1.02; 95% CI, 1.00 to 1.04; P = 0.039), group 2 carbapenems (aHR, 1.03; 95% CI, 1.00 to 1.07; P = 0.041), and ertapenem (aHR, 1.08; 95% CI, 1.02 to 1.14; P = 0.004). The epidemiology of MDR P. aeruginosa is complex, and different clusters may coexist. Interestingly, ertapenem was found to be associated with the emergence of MDR isolates.
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