Nosocomial infection by multi-drug resistant Pseudomonas aeruginosa: case-control study
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Abstract
Objective: To identify the risk factors of healthcare-associated infection (HAI) by multi-drug resistant P. aeruginosa (MDR-PA) at a high-complexity hospital.
Methods: Case-control study in adults with a first isolation of HAI by P. aeruginosa admitted for ≥48 hours to a Medellin, Colombia hospital between 2005 and 2006. Case was defined as infection by MDR-PA resistant to ≥3 types of antibiotics, and control was defined as sensitive infection determined by Vitek-1 automated system. Demographical information, medical history, admission diagnoses, hospitalization service at time of infection diagnosis, hospitalization time prior to infection, invasive procedures and antibiotic therapy were all identified from medical records. Odds ratios and 95% confidence intervals were estimated and Student’s t-test and Mann-Whitney test were used to compare quantitative variables. A logistic regression model was used to identify factors independent from MDR-PA infection.
Results: Fifty-four cases and 85 controls were included, without differences in demographic information, comorbilities, admissions diagnoses, or previous surgery. Associations were observed between MDR-PA, hospitalization service at time of infection diagnosis, β-lactams, aminoglycosides, quinolones, carbapenem, vancomycin, open abdomen, urinary catheter, central venous catheter, radial catheter and mechanical ventilation. Median hospital stay prior to infection was higher in cases than controls, P value=0.005. The use of β-lactams OR 4.55 (CI95% 21.24-16.70), quinolones OR 7.23 (CI95% 2.71-19.82) and mechanical ventilation OR 4.85 (CI95% 2.04-11.49) were identified as independent risk factors for HAI by MDR-PA.
Conclusion: the use of β-lactam antibiotics, quinolones, and mechanical ventilation increase the risk of HAI by MDR-PA.
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References
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