{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T12:11:34Z","timestamp":1790079094440,"version":"4.0.1"},"reference-count":34,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2015,1,2]],"date-time":"2015-01-02T00:00:00Z","timestamp":1420156800000},"content-version":"unspecified","delay-in-days":1827,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2010,1]]},"abstract":"<jats:sec id=\"S0195941700028472_abs1\"><jats:title>Background.<\/jats:title><jats:p><jats:italic>Pseudomonas aeruginosa<\/jats:italic> is one of the most common gram-negative hospital-acquired pathogens. Resistance of this organism to imipenem complicates treatment.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700028472_abs2\"><jats:title>Objective.<\/jats:title><jats:p>To elucidate the risk factors for imipenem-resistant <jats:italic>P. aeruginosa<\/jats:italic> (IRPA) infection or colonization and to identify the effect of resistance on clinical and economic outcomes.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700028472_abs3\"><jats:title>Methods.<\/jats:title><jats:p>Longitudinal trends in prevalence of IRPA from 2 centers were characterized during the period from 1989 through 2006. For <jats:italic>P. aeruginosa<\/jats:italic> isolates obtained during the period from 2001 through 2006, a case-control study was conducted to investigate the association between prior carbapenem use and IRPA infection or colonization, and a cohort study was performed to identify the effect of IRPA infection or colonization on mortality, length of stay after culture, and hospital cost after culture.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700028472_abs4\"><jats:title>Results.<\/jats:title><jats:p>From 1989 through 2006, the proportion of <jats:italic>P. aeruginosa<\/jats:italic> isolates demonstrating resistance to imipenem increased from 13% to 20% (<jats:italic>P<\/jats:italic>&lt; .001, trend). During the period from 2001 through 2006, there were 2,542 unique patients with <jats:italic>P. aeruginosa<\/jats:italic> isolates, and 253 (10.0%) had IRPA isolates. Prior carbapenem use was independently associated with IRPA infection or colonization (adjusted odds ratio [OR], 7.92 [95% confidence interval {CI}, 4.78-13.11]). Patients with an IRPA isolate recovered had higher in-hospital mortality than did patients with an imipenem-susceptible <jats:italic>P. aeruginosa<\/jats:italic> isolate (17.4% vs 13.4%; <jats:italic>P<\/jats:italic> = .01). IRPA infection or colonization was an independent risk factor for mortality among patients with isolates recovered from blood (adjusted OR, 5.43 [95% CI, 1.72-17.10]; <jats:italic>P<\/jats:italic> = .004) but not among patients with isolates recovered from other anatomic sites (adjusted OR, 0.78 [95% CI, 0.51-1.21]; <jats:italic>P<\/jats:italic> = .27). Isolation of IRPA was associated with longer hospital stay after culture (<jats:italic>P<\/jats:italic>&lt;.001) and greater hospital cost after culture (<jats:italic>P<\/jats:italic>&lt;.001) than was isolation of an imipenem-susceptible strain. In multivariable analysis, IRPA infection or colonization remained an independent risk factor for both longer hospital stay after culture (coefficient, 0.20 [95% CI, 0.04-0.36]; <jats:italic>P<\/jats:italic> = .02) and greater hospital cost after culture (coefficient, 0.30 [95% CI, 0.06-0.54]; <jats:italic>P<\/jats:italic> = .02).<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700028472_abs5\"><jats:title>Conclusions.<\/jats:title><jats:p>The prevalence of IRPA infection or colonization has increased significantly, with important implications for both clinical and economic outcomes. Interventions to curb this continued increase and strategies to optimize therapy are urgently needed.<\/jats:p><\/jats:sec>","DOI":"10.1086\/649021","type":"journal-article","created":{"date-parts":[[2009,12,1]],"date-time":"2009-12-01T19:57:55Z","timestamp":1259697475000},"page":"47-53","source":"Crossref","is-referenced-by-count":92,"title":["Imipenem Resistance in <i>Pseudomonas aeruginosa<\/i> Emergence, Epidemiology, and Impact on Clinical and Economic Outcomes"],"prefix":"10.1017","volume":"31","author":[{"given":"Ebbing","family":"Lautenbach","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Synnestvedt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark G.","family":"Weiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warren B.","family":"Bilker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lien","family":"Vo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Schein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myoung","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2015,1,2]]},"reference":[{"key":"S0195941700028472_ref013","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.46747-0"},{"key":"S0195941700028472_ref032","doi-asserted-by":"publisher","DOI":"10.1086\/322667"},{"key":"S0195941700028472_ref024","doi-asserted-by":"publisher","DOI":"10.1086\/507288"},{"key":"S0195941700028472_ref030","doi-asserted-by":"publisher","DOI":"10.2307\/30141013"},{"key":"S0195941700028472_ref026","doi-asserted-by":"publisher","DOI":"10.1086\/338237"},{"key":"S0195941700028472_ref031","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.162.21.2469"},{"key":"S0195941700028472_ref027","doi-asserted-by":"publisher","DOI":"10.1086\/516092"},{"key":"S0195941700028472_ref028","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1128\/AAC.43.6.1379","article-title":"Emergence of antibiotic-resistant Pseudomonas aeruginosa: comparison of risks associated with different antipseudomonal agents","volume":"43","author":"Carmeli","year":"1999","journal-title":"Antimicrob Agents Chemother"},{"key":"S0195941700028472_ref022","doi-asserted-by":"publisher","DOI":"10.1016\/0196-6553(88)90053-3"},{"key":"S0195941700028472_ref014","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2006.04.014"},{"key":"S0195941700028472_ref011","first-page":"M100","volume-title":"Performance standards for antimicrobial susceptibility testing: 11th informational supplement. 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