Risk factors for carbapenem-nonsusceptible Pseudomonas aeruginosa: Case-control study

Diagn Microbiol Infect Dis. 2017 Oct;89(2):146-150. doi: 10.1016/j.diagmicrobio.2017.06.017. Epub 2017 Jul 1.

Abstract

The objective of this case case-control study was to identify risk factors for carbapenem-nonsusceptible Pseudomonas aeruginosa in adult acute care hospitalized patient at 2 large academic medical centers. Risk factors were evaluated using logistic regression within a generalized estimating equations framework to account for clustering of patients within study site. Of 1161 total isolates, 271 (23.3%) were carbapenem-nonsusceptible of which respiratory was the most common source (54.3%). In the multivariable model, intra-abdominal (P < 0.0001) and respiratory (P = 0.0014) sources were associated with a higher odds for carbapenem nonsusceptibility when compared to urine source. Prior positive culture (P < 0.0001), use of an antipseudomonal carbapenem in the prior 30 days (P < 0.0001) and culture collection in the intensive care unit (P < 0.0001) were also associated with increased odds for carbapenem-nonsusceptibility. Further studies to validate these findings are warranted.

Keywords: Carbapenem; Nonsusceptible; Pseudomonas aeruginosa; Risk factors.

Publication types

  • Multicenter Study

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Carbapenems / therapeutic use*
  • Case-Control Studies
  • Female
  • Humans
  • Intensive Care Units
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Pseudomonas Infections / drug therapy*
  • Pseudomonas Infections / microbiology
  • Pseudomonas aeruginosa / drug effects*
  • Pseudomonas aeruginosa / genetics
  • Pseudomonas aeruginosa / isolation & purification
  • Respiratory Tract Infections / drug therapy
  • Respiratory Tract Infections / microbiology
  • Risk Factors
  • Urinary Tract Infections / drug therapy
  • Urinary Tract Infections / microbiology
  • beta-Lactam Resistance / ethnology*

Substances

  • Anti-Bacterial Agents
  • Carbapenems