Lack of effect of fluoroquinolone resistance on mortality in subjects with Pseudomonas aeruginosa bacteraemia

J Infect. 2006 Feb;52(2):105-10. doi: 10.1016/j.jinf.2005.03.007.

Abstract

Objectives: Despite the well-documented increase in fluoroquinolone resistance to Pseudomonas aeruginosa, the effect on pathogenicity is unknown. This paper will explore the clinical effect.

Methods: A retrospective, observational, cohort study of 215 hospital inpatients was performed. Subjects with fluoroquinolone-resistant P. aeruginosa (FQRPA) bacteraemia were compared to subjects with fluoroquinolone-sensitive P. aeruginosa (FQSPA) bacteraemia from January 2000 to December 2003. Mortality prior to discharge, time to discharge, and time to negative culture were assessed. Additionally, baseline morbidity/mortality risk factors including Charlson morbidity score (CMS) were assessed.

Results: Mortality prior to discharge (32 vs. 29%, P=0.73), mean days to discharge (17.5 vs. 14.6, P=0.24), and mean days to negative culture (3.6 vs. 3.2, P=0.1) did not differ between FQRPA and FQSPA, respectively. Active antibiotic treatment within 24h of drawn blood culture (FQRPA 63% vs. FQSPA 93%, P<0.0001) and median CMS (FQRPA 3 vs. FQSPA 5, P=0.004) differed significantly between the groups.

Conclusions: Subjects with FQRPA received active antibiotics less often within 24h of obtained culture. A large difference in mortality does not likely exist based on fluoroquinolone susceptibility. A study with greater enrollment must be conducted to determine if fluoroquinolone resistance imparts a smaller yet clinically significant impact on clinical outcomes.

MeSH terms

  • Bacteremia / drug therapy*
  • Bacteremia / microbiology
  • Bacteremia / mortality*
  • Cohort Studies
  • Female
  • Fluoroquinolones / pharmacology*
  • Fluoroquinolones / therapeutic use
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Pseudomonas Infections / drug therapy*
  • Pseudomonas Infections / mortality*
  • Pseudomonas aeruginosa / drug effects*
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Fluoroquinolones