Journal of Vascular Surgery
Volume 50, Issue 4 , Pages 806-812 , October 2009

The consequences of an outbreak of multidrug-resistant Pseudomonas aeruginosa among patients treated for critical leg ischemia

  • Maria Söderström, MD

      Affiliations

    • Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland
    • Corresponding Author InformationCorrespondence: Maria Söderström, MD, Department of Vascular Surgery, Helsinki University Central Hospital, Finland
  • ,
  • Pirkka Vikatmaa, MD

      Affiliations

    • Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland
  • ,
  • Mauri Lepäntalo, MD, PhD

      Affiliations

    • Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland
  • ,
  • Pekka-Sakari Aho, MD, PhD

      Affiliations

    • Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland
  • ,
  • Elina Kolho, MD, PhD

      Affiliations

    • Department of Internal Medicine, Division of Infectious Diseases, Helsinki University Central Hospital, Helsinki, Finland
  • ,
  • Tuija Ikonen, MD, PhD

      Affiliations

    • Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland
    • Department of Surgery, Turku University Central Hospital, Helsinki, Finland

Received 29 March 2009 ,Accepted 29 May 2009.

  • Image Result

    Kaplan-Meier curves demonstrate amputation-free survival in the multidrug-resistant Pseudomonas aeruginosa (MDR Pa) group and in the control group. At 1 year after the bypass, patients with MDR Pa sho

    Kaplan-Meier curves demonstrate amputation-free survival in the multidrug-resistant Pseudomonas aeruginosa (MDR Pa) group and in the control group. At 1 year after the bypass, patients with MDR Pa showed significantly decreased amputation-free survival (P = .020; χ2 test). After 5-year follow-up, the amputation-free survival was poor in both groups (P = .144, Kaplan-Meier analysis). The standard error is <10% at each time point in the curve.

  • Image Result
    Survival rates after infrainguinal bypass surgery due to critical limb ischemia in the multidrug-resistant Pseudomonas aeruginosa (MDR Pa) group and in the control group demonstrated by Kaplan-Meier a

    Survival rates after infrainguinal bypass surgery due to critical limb ischemia in the multidrug-resistant Pseudomonas aeruginosa (MDR Pa) group and in the control group demonstrated by Kaplan-Meier analysis. The survival was lower in the MDR Pa group at 1 year compared with the control group, but the difference did not reach statistical significance (P = .063). Both groups showed low survival rates in long-term follow-up (P = .302). The standard error is <10% at each time point in the curve.

  • Image Result
    Kaplan-Meier curves demonstrate the leg salvage. The leg salvage rate was lower in the multidrug-resistant Pseudomonas aeruginosa (MDR Pa) group at 1 year (P = .078) and at 5 years after infrainguinal

    Kaplan-Meier curves demonstrate the leg salvage. The leg salvage rate was lower in the multidrug-resistant Pseudomonas aeruginosa (MDR Pa) group at 1 year (P = .078) and at 5 years after infrainguinal bypass surgery (P = .126) compared with the control group, but the differences were not significant. The standard error is <10% at each time point in the curve.

  • Image Result
    Kaplan-Meier life-table curves demonstrate secondary patency in the multidrug-resistant Pseudomonas aeruginosa (MDR Pa) group and in the control group. The difference in the secondary patency rate bet

    Kaplan-Meier life-table curves demonstrate secondary patency in the multidrug-resistant Pseudomonas aeruginosa (MDR Pa) group and in the control group. The difference in the secondary patency rate between the MDR Pa group and the control group was not significant (P = .149). Graft patency was monitored until 1 year after the infrainguinal bypass surgery, determined by clinical examination, duplex Doppler imaging, and the ankle-brachial index. The standard error is <10% at each time point in the curve.

 Competition of interest: none.

PII: S0741-5214(09)01228-2

doi: 10.1016/j.jvs.2009.05.063

Journal of Vascular Surgery
Volume 50, Issue 4 , Pages 806-812 , October 2009