Multidrug-resistant Pseudomonas aeruginosa infections pose growing threat to health care-associated infection control in the hospitals of Southern China: a case-control surveillance study

Am J Infect Control. 2014 Dec;42(12):1308-11. doi: 10.1016/j.ajic.2014.08.006. Epub 2014 Oct 16.

Abstract

Background: Multidrug-resistant Pseudomonas aeruginosa (MDRPA) is one of the most common agents among health care-associated infections. There is a lack of data on the clinical features of MDRPA from Southern China.

Methods: A case-control surveillance study of P aeruginosa was conducted based on surveillance from July 2008-December 2012, in 5 hospitals of Guangzhou, China. Data were analyzed by univariate analysis and multivariate logistic regression using Stata 13 (StataCorp, College Station, TX).

Results: Of the 348 P aeruginosa strains, the prevalence of MDRPA was 54%, and it has increased over time. Isolates of P aeruginosa showed increased resistance to most antimicrobials during this time period. Independent risk factors were tracheal intubation insertion (odds ratio [OR], 2.21; 95% confidence interval [CI], 1.16-4.23; P = .02) and use of carbapenem (odds ratio [OR], 3.36; 95% confidence interval [CI], 1.75-6.47; P < .01). The distribution of MDRPA infections was uneven among the 5 hospitals (P = .01). Being infected with MDRPA strains resulted in longer duration of hospitalization (39 vs 24 days) and higher mortality (49% vs 20%).

Conclusion: The infections of MDRPA were severe issues. More stringent measures should be applied for those with independent predictors of MDRPA infections because they may induce adverse clinical outcomes.

Keywords: Case-control surveillance; Multidrug-resistant Pseudomonas aeruginosa; Southern China.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Carbapenems / therapeutic use
  • Case-Control Studies
  • China / epidemiology
  • Communicable Diseases / epidemiology*
  • Communicable Diseases / microbiology
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • Drug Resistance, Multiple, Bacterial
  • Epidemiological Monitoring
  • Female
  • Hospitalization
  • Hospitals
  • Humans
  • Infection Control / standards*
  • Intubation, Intratracheal / adverse effects
  • Logistic Models
  • Prevalence
  • Pseudomonas Infections / epidemiology*
  • Pseudomonas Infections / microbiology
  • Pseudomonas aeruginosa / drug effects
  • Pseudomonas aeruginosa / genetics
  • Pseudomonas aeruginosa / isolation & purification*
  • Risk Factors

Substances

  • Anti-Bacterial Agents
  • Carbapenems