@article{3099674,
    title = "Multidrug resistance to antimicrobials as a predominant factor
influencing patient survival",
    author = "Giamarellos-Bourboulis, Evangelos J. and Papadimitriou, Evangelia and and Galanakis, Nearchos and Antonopoulou, Anastasia and Tsaganos, Thomas and and Kanellakopoulou, Kyriaki and Giamarellou, Helen",
    journal = "International Journal of Antimicrobial Agents",
    year = "2006",
    volume = "27",
    number = "6",
    pages = "476-481",
    publisher = "Elsevier",
    issn = "0924-8579",
    doi = "10.1016/j.ijantimicag.2005.12.013",
    keywords = "multiresistance; risk factor; survival",
    abstract = "The impact of multidrug resistance to antimicrobials was assessed in a
cohort of 243 patients with microbiologically documented infections by a
variety of susceptible and multidrug-resistant (MDR) species. Multidrug
resistance was defined as resistance to more than two antimicrobial
agents of different chemical structure. Cox regression analysis was
performed to define differences and the significance of any predisposing
factors. Overall survival of patients infected by susceptible isolates
was prolonged compared with patients infected by MDR isolates (P =
0.013). Mortality rates of infections caused by susceptible and MDR
isolates were 4.87% and 16.15%, respectively (P = 0.013); the higher
mortality rate for MDR isolates was more pronounced for infections by
Klebsiella pneumoniae and Pseudomonas aeruginosa. Mean (+/- standard
error (S.E.)) survival of patients infected by susceptible and MDR
isolates in patients without signs of severe sepsis was 28 days and
27.29 +/- 0.35 days, respectively (P = not significant). Mean (S.E.)
survival of patients with severe sepsis caused by susceptible and MDR
isolates was 7.70 +/- 4.62 days and 10.45 +/- 2.18 days, respectively (P
= 0.048). Diabetes mellitus type 2, the presence of severe sepsis and
any underlying malignancy were the most important risk factors affecting
survival. It is concluded that infections by MDR isolates were
accompanied by higher mortality rates and decreased survival compared
with infections by susceptible isolates. Diabetes mellitus type 2 and
underlying malignancies were significant co-morbid conditions, whereas
survival after infection by susceptible isolates was particularly
decreased in the event of severe sepsis. (c) 2006 Elsevier B.V. and the
International Society of Chemotherapy. All rights reserved."
}