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Risk Factors for Acquisition of Fluoroquinolone or Aminoglycoside Resistance in Addition to Carbapenem Resistance in Pseudomonas aeruginosa



Kosuke Kosai1, *, Norihito Kaku2, Naoki Uno2, Tomomi Saijo3, Yoshitomo Morinaga2, Yoshifumi Imamura3, Hiroo Hasegawa1, Taiga Miyazaki4, Koichi Izumikawa4, Hiroshi Mukae3, Katsunori Yanagihara2
1 Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
2 Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
3 Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
4 Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan


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© 2018 Kosai et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.





Risk Factors for Acquisition of Fluoroquinolone or Aminoglycoside Resistance in Addition to Carbapenem Resistance in Pseudomonas Aeruginosa

The Open Microbiology Journal, 2017, 11-92

The correct Table 2 is mentioned below:

Table 2. Univariate and multivariate analyses of risk factors for acquisition of fluoroquinolone or aminoglycoside resistance in addition to imipenem resistance in Pseudomonas aeruginosa.
Univariate analysis Multivariate analysis
OR 95%CI P OR 95%CI P
Resistance to FQs
Transplantation 1.74 0.80-3.78 0.161
Use of corticosteroids (≥5 mg/day) or other immunosuppressive agents 1.81 0.93-3.52 0.082
  Surgery 0.65 0.35-1.21 0.173
  Exposure to first-generation cephalosporins 0.60 0.30-1.19 0.143
  Exposure to second-generation cephalosporins 0.28 0.08-1.01   0.051
Exposure to FQs 5.30 2.52-11.14 <0.001 5.73 2.67-12.30 <0.001
Exposure to AGs 3.92 1.30-11.87 0.016
MBL production 6.67 1.78-24.91 0.005 7.90 2.01-31.04   0.003
Resistance to AGs
Use of anticancer drugs 2.57 0.64-10.40 0.184
Use of urinary catheter 0.42 0.13-1.38 0.152
  Exposure to antipseudomonal penicillins 0.24 0.05-1.14 0.073 0.16 0.03-0.89   0.036
Exposure to AGs 6.04 1.59-23.00 0.008 9.00 1.92-42.19   0.005
MBL production 7.35 1.89-28.65 0.004 8.49 1.87-38.52   0.006
OR, odds ratio; CI, confidence interval; FQs, fluoroquinolones; AGs, aminoglycosides; MBL, metallo-β-lactamase

The original table provided was:

Table 2. Proportion of resistant and MBL-producing strains by presence of FQ or AG resistance in imipenem-resistant Pseudomonas aeruginosa.
Resistance to FQs Resistance to AGs
All strains
(n = 169)
Yes
(n = 66)
No
(n = 103)
P Yes
(n = 12)
No
(n= 157)
P
Resistance to antibiotics
Piperacillin1) 36 (21.3) 21 (31.8) 15 (14.6) 0.003 4 (33.3) 32 (20.4) 0.347
Ceftazidime1) 53 (31.4) 33 (50.0) 20 (19.4) <0.001 8 (66.7) 45 (28.7) 0.022
Cefepim 38 (22.5) 28 (42.4) 10 (9.7) <0.001 7 (58.3) 31 (19.7) 0.006
Aztreonam 91 (53.8) 45 (68.2) 46 (44.7) 0.004 9 (75.0) 82 (52.2) 0.146
Ciprofloxacin1) 49 (29.0) - - - 8 (66.7) 41 (26.1) 0.011
Levofloxacin 60 (35.5) - - - 6 (50.0) 54 (34.4) 0.350
Gentamicin1) 12 (7.1) 8 (12.1) 4 (3.9) 0.042 - - -
Amikacin1) 4 (2.4) 3 (4.5) 1 (1.0) 0.274 - - -
MBL production 14 (8.3) 11 (16.7) 3 (2.9) 0.003 4 (33.3) 10 (6.4) 0.010
Values are expressed as the number (%).
FQs, fluoroquinolones; AGs, aminoglycosides; MBL, metallo-β-lactamase 1)Minimum inhibitory concentrations (MICs) for piperacillin, ceftazidime, ciprofloxacin, gentamicin and amikacin were not measured in eleven, one, one, one, and thirteen strains, respectively.