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Mortality in patients with multidrug-resistant Pseudomonas aeruginosa infections: a meta-analysis

Eliseth Costa Oliveira de Matos1, Regis Bruni Andriolo2, Yan Corrêa Rodrigues2

  • 1Departamento de Patologia, Universidade do Estado do Pará, Belém, PA, Brasil.

Revista Da Sociedade Brasileira De Medicina Tropical
|August 23, 2018
PubMed

Insights

Multidrug-resistant Pseudomonas aeruginosa (MDRPA) significantly increases mortality risk in hospital infections. While São Paulo MBL-1 (SPM-1) strains showed no significant mortality difference, MDRPA infections are linked to higher death rates, especially in bloodstream infections.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Public Health

Background:

  • Pseudomonas aeruginosa is a major cause of hospital-acquired infections.
  • Limited treatment options exist for multidrug-resistant (MDRPA) and metallo-beta-lactamase (MBL)-producing strains.
  • High mortality rates are associated with these resistant strains.

Purpose of the Study:

  • To conduct a meta-analysis on the association between MDRPA and São Paulo MBL-1 (SPM-1) producing strains and mortality.
  • To analyze mortality rates in patients infected with P. aeruginosa.

Main Methods:

  • A systematic literature search was performed on online databases for studies published between 2006 and 2016.
  • A meta-analysis included 15 studies with 3,201 cases of P. aeruginosa infection.
  • Statistical analysis was used to determine odds ratios and confidence intervals for mortality.

Main Results:

  • Patients with MDRPA infections had a significantly higher mortality rate (44.6%) compared to non-MDRPA infections (24.8%).
  • The odds ratio for mortality in MDRPA infections was 2.39 (95% CI 1.70-3.36, p <0.00001).
  • No statistically significant difference in mortality was observed between SPM-1 and non-SPM-1 strains (p = 0.43).

Conclusions:

  • MDRPA infections are associated with a significantly higher mortality rate than non-MDRPA infections.
  • Higher mortality was noted in patients with bloodstream infections, immunosuppression, and inadequate antimicrobial therapy.
  • Further research is needed on the molecular aspects of resistance and nosocomial settings.

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