Impact of AmpC overexpression on outcomes of patients with Pseudomonas aeruginosa bacteremia |
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Authors: | Vincent H. Tam Kai-Tai Chang Amy N. Schilling Mark T. LaRocco Layne O. Genty Kevin W. Garey |
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Affiliation: | 1. University of Houston College of Pharmacy, Houston, TX 77030, USA;2. St. Luke''s Episcopal Hospital, Houston, TX 77030, USA |
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Abstract: | AmpC overexpression (AmpC++) is a significant mechanism of β-lactam resistance in Pseudomonas aeruginosa, but its impact on clinical outcomes is not well established. To examine the influence of AmpC++ on clinical outcomes of patients with P. aeruginosa bacteremia, we screened all bloodstream P. aeruginosa isolates obtained from 2003 to 2006 for AmpC++. Demographics and outcomes were retrospectively compared between patients with P. aeruginosa bacteremia caused by AmpC++ and pan-susceptible strains (wild-type controls). Of the 263 isolates screened, 63 (24.0%) were nonsusceptible to ceftazidime. Clinical data of 42 AmpC++ isolates from 21 patients were compared with 33 control patients. The 2 groups were similar in sex and race. Patients in the AmpC++ group was more likely to receive inappropriate empiric antibiotics (odds ratio [OR] = 67.5; 95% confidence interval [CI], 6.3–720.0) and experience microbiologic persistence (OR = 12.2; 95% CI, 1.7–87.7). In institutions with a high prevalence of AmpC++, empiric therapy with agents with activity against AmpC++ strains may be warranted. |
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Keywords: | AmpC overexpression Pseudomonas aeruginosa Outcomes |
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