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Multidrug-resistant organisms did not increase mortality in pneumonia patients
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Patients with severe pneumonia did not experience a rise in mortality rates despite coinfection with multidrug-resistant organisms — such as methicillin-resistant Staphylococcus aureus; extended-spectrum beta-lactamase–producing gram-negative bacilli; and carbapenem-resistant Pseudomonas and Acinetobacter, according to results presented at the Fifth Decennial International Conference on Healthcare-Associated Infections in Atlanta.
Researchers from the National University Health System in Singapore conducted a prospective observational study to evaluate the effect that multidrug-resistant organisms had on the mortality of patients with community- and health care–associated pneumonia. The study involved patients who stayed for more than 24 hours in the hospital’s ICU between August 2007 and August 2008.
The ICU admitted 230 patients with pneumonia, according to the researchers. The mean age was 61.6 years, 67.4% were men and 51.7% had community-associated pneumonia. Comorbidities included diabetes (42.6%) and renal impairment (38%), with half requiring dialysis.
The researchers reported that there were 51 patients with pneumonia associated with the following multidrug-resistant organisms: 28 with MRSA, nine with extended-spectrum beta-lactamase gram-negatives, 10 with carbapenem-resistant Acinetobacter and four with Pseudomonas.
Results indicated that 40 of these patients had hospital-associated multidrug-resistant organisms, according to the researchers, although analysis showed this had no effect on mortality (OR=1.25; 95% CI, 0.56-2.79).
The researchers concluded that infection related to multidrug-resistant organisms was not independently associated with mortality in the patients with pneumonia. They noted, however, that adjusting for severity of illness when assessing the effect of multidrug-resistant organisms in critically ill patients is crucial when selecting the appropriate course of initial broad-spectrum antimicrobial therapy. – by Melissa Foster
Editorial Note
The numbers of patients in this study really don’t permit any conclusions about specific multidrug-resistant organisms and mortality. – Theodore C. Eickhoff, MD
For more information:
- Vasudevan A. Multi-drug resistant organisms (MDRO) are not an independent risk factor for mortality in patients with pneumonia—the importance of adjusting for comorbidities and severity of illness. #163. Presented at: Fifth Decennial International Conference on Healthcare-Associated Infections; March 18-22, 2010; Atlanta.