BACKGROUND/PURPOSE: @entity2893 -resistant @entity796 @entity281 have been a challenge and issue in hospital settings. However, the clinical impact of @entity796 blood isolates resistant only to carbapenems has never been discussed previously. METHODS: To assess the risk factors and clinical significance of @entity2259 caused by @entity2893 resistance only @entity796 (CROPA), a 6-year retrospective case-control study was conducted. The CROPA strains were defined as isolates susceptible to @entity2177 , antipseudomonal @entity114 and @entity2886 , and @entity581 but resistant to one antipseudomonal @entity2893 ( @entity2892 or @entity2889 ) or both. The controls were selected among @entity1 with @entity2259 due to @entity796 susceptible to all above classes of antipseudomonal antibiotics, which was defined as all-susceptible @entity796 . RESULTS: Twenty-five @entity1 had at least one blood culture positive for CROPA, and 50 controls had all-susceptible @entity796 @entity2259 . CROPA @entity2259 had a high 30-day mortality rate (72.0%), as compared to 26.0% for the controls (p  <  0.001). Through multivariate analysis, @entity2893 exposure was the only risk factor for developing CROPA @entity2259 (p  =  0.002). A comparison between the surviving and deceased @entity1 with CROPA @entity2259 showed that nine (50%) of those who died, but none of the survivors, received carbapenems as the initial empirical therapy (p  =  0.027). CONCLUSION: @entity2893 exposure was associated with emergence of CROPA @entity281 . Repeated @entity2893 use in such @entity1 might increase rates of inappropriate initial empirical treatment and mortality. Prudent @entity2893 use is important to reduce the emergence of CROPA.

Risk factors and clinical significance of @entity2259 caused by XXXX resistant only to carbapenems.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity2892 :: ('MESH:D015378', 'Chemical') :: ['imipenem'] @entity796 :: ('287', 'Species') :: ['Pseudomonas aeruginosa', 'P. aeruginosa'] @entity114 :: ('MESH:D010406', 'Chemical') :: ['penicillins'] @entity2177 :: ('MESH:D002939', 'Chemical') :: ['ciprofloxacin'] @entity2889 :: ('MESH:C059500', 'Chemical') :: ['meropenem'] @entity2886 :: ('MESH:D002511', 'Chemical') :: ['cephalosporins'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infections'] @entity2893 :: ('CHEBI:46765', 'Chemical') :: ['carbapenem', 'Carbapenem'] @entity581 :: ('MESH:D000617', 'Chemical') :: ['aminoglycosides'] @entity2259 :: ('MESH:D016470', 'Disease') :: ['bacteremia']
@entity796 :: (287,Species) :: ['Pseudomonas aeruginosa']
