Risk factors, antimicrobial susceptibility pattern and patient outcomes of Pseudomonas aeruginosa infection: A matched case-control study
Background: Pseudomonas aeruginosa is a leading nosocomial Gram-negative bacteria associated with prolonged hospitalization, and increased morbidity and mortality. Limited data exist regarding P. aeruginosa infection and outcome in patients managed in intensive care units (ICUs) in the Gulf countrie...
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Elsevier
2021-01-01
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Online Access: | http://www.sciencedirect.com/science/article/pii/S1876034120307498 |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Fatima A. Alhussain Nagarajkumar Yenugadhati Fahad A. Al Eidan Sameera Al Johani Motasim Badri |
spellingShingle |
Fatima A. Alhussain Nagarajkumar Yenugadhati Fahad A. Al Eidan Sameera Al Johani Motasim Badri Risk factors, antimicrobial susceptibility pattern and patient outcomes of Pseudomonas aeruginosa infection: A matched case-control study Journal of Infection and Public Health Pseudomonas aeruginosa Infection Risk factors Resistance Intensive care unit |
author_facet |
Fatima A. Alhussain Nagarajkumar Yenugadhati Fahad A. Al Eidan Sameera Al Johani Motasim Badri |
author_sort |
Fatima A. Alhussain |
title |
Risk factors, antimicrobial susceptibility pattern and patient outcomes of Pseudomonas aeruginosa infection: A matched case-control study |
title_short |
Risk factors, antimicrobial susceptibility pattern and patient outcomes of Pseudomonas aeruginosa infection: A matched case-control study |
title_full |
Risk factors, antimicrobial susceptibility pattern and patient outcomes of Pseudomonas aeruginosa infection: A matched case-control study |
title_fullStr |
Risk factors, antimicrobial susceptibility pattern and patient outcomes of Pseudomonas aeruginosa infection: A matched case-control study |
title_full_unstemmed |
Risk factors, antimicrobial susceptibility pattern and patient outcomes of Pseudomonas aeruginosa infection: A matched case-control study |
title_sort |
risk factors, antimicrobial susceptibility pattern and patient outcomes of pseudomonas aeruginosa infection: a matched case-control study |
publisher |
Elsevier |
series |
Journal of Infection and Public Health |
issn |
1876-0341 |
publishDate |
2021-01-01 |
description |
Background: Pseudomonas aeruginosa is a leading nosocomial Gram-negative bacteria associated with prolonged hospitalization, and increased morbidity and mortality. Limited data exist regarding P. aeruginosa infection and outcome in patients managed in intensive care units (ICUs) in the Gulf countries. We aimed to determine the risk factors, antimicrobial susceptibility pattern and patient outcomes of P. aeruginosa infection in ICU. Methods: In this matched case-control study, all P. aeruginosa infections that occurred >48 h after hospital admission between January 31st 2016 and December 31st 2018 at ICUs affiliated with King Abdulaziz Medical City, Riyadh were included. P. aeruginosa was identified using MALDI-TOF (Vitek-MS) by biomérieux, and the antimicrobial susceptibility testing was performed using an automated biomérieux VITEK®️ 2 Antimicrobial Susceptibility card. Results: The study included 90 cases and 90 controls. Compared with controls, cases had significantly higher mean ICU stay and higher proportions with previous history of antimicrobial therapy, coronary artery disease, malignancy, hemodialysis, previous surgery, use of central line, urethral catheterization, nasogastric tube, and tracheostomy. In a multivariate conditional logistic regression analysis, factors independently associated with P. aeruginosa infection were ICU duration [Odds Ratio (OR) 9.05, 95%CI 2.53−32.27, p = .001], previous surgery (OR = 7.33, 95%CI 1.66−32.36, p = .009), tracheostomy (OR = 11.13, 95%CI 1.05−118.59, p = .046), urethral catheterization (OR = 7.38, 95%CI 1.21−45.11, p = .030) and use of aminoglycosides (OR = 10.59, 95%CI 1.14−98.13, p = .038). Approximately 41% of P. aeruginosa isolates were resistant to imipenem, while 36.7% were multidrug-resistant. Mortality was similar in both groups: 54(60%) cases and 51(56.7%) controls; p = .650. Conclusions: The study identifies several potentially modifiable factors associated with P. aeruginosa infection in ICUs. Identification of these factors could facilitate case identification and enhance control measures. |
topic |
Pseudomonas aeruginosa Infection Risk factors Resistance Intensive care unit |
url |
http://www.sciencedirect.com/science/article/pii/S1876034120307498 |
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spelling |
doaj-672828acb3374d5189d3e03629cf060e2021-01-30T04:27:05ZengElsevierJournal of Infection and Public Health1876-03412021-01-01141152157Risk factors, antimicrobial susceptibility pattern and patient outcomes of Pseudomonas aeruginosa infection: A matched case-control studyFatima A. Alhussain0Nagarajkumar Yenugadhati1Fahad A. Al Eidan2Sameera Al Johani3Motasim Badri4College of Public Health & Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Centre, King Abdulaziz Medical City, Riyadh, Saudi Arabia; Almithnab General Hospital, AlQassim, Saudi ArabiaCollege of Public Health & Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Centre, King Abdulaziz Medical City, Riyadh, Saudi ArabiaCollege of Public Health & Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaCollege of Public Health & Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; College of Sciences and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaCollege of Public Health & Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Centre, King Abdulaziz Medical City, Riyadh, Saudi Arabia; Corresponding author at: Department of Epidemiology & Biostatistics, College of Public Health & Health Informatics, King Saud bin Abdulaziz University for Health Sciences (www.ksau-hs.edu.sa), King Abdulaziz Medical City, Health Affairs, Ministry of National Guard, Mail Code 2350, PO Box 3660, Riyadh 11481, Saudi Arabia.Background: Pseudomonas aeruginosa is a leading nosocomial Gram-negative bacteria associated with prolonged hospitalization, and increased morbidity and mortality. Limited data exist regarding P. aeruginosa infection and outcome in patients managed in intensive care units (ICUs) in the Gulf countries. We aimed to determine the risk factors, antimicrobial susceptibility pattern and patient outcomes of P. aeruginosa infection in ICU. Methods: In this matched case-control study, all P. aeruginosa infections that occurred >48 h after hospital admission between January 31st 2016 and December 31st 2018 at ICUs affiliated with King Abdulaziz Medical City, Riyadh were included. P. aeruginosa was identified using MALDI-TOF (Vitek-MS) by biomérieux, and the antimicrobial susceptibility testing was performed using an automated biomérieux VITEK®️ 2 Antimicrobial Susceptibility card. Results: The study included 90 cases and 90 controls. Compared with controls, cases had significantly higher mean ICU stay and higher proportions with previous history of antimicrobial therapy, coronary artery disease, malignancy, hemodialysis, previous surgery, use of central line, urethral catheterization, nasogastric tube, and tracheostomy. In a multivariate conditional logistic regression analysis, factors independently associated with P. aeruginosa infection were ICU duration [Odds Ratio (OR) 9.05, 95%CI 2.53−32.27, p = .001], previous surgery (OR = 7.33, 95%CI 1.66−32.36, p = .009), tracheostomy (OR = 11.13, 95%CI 1.05−118.59, p = .046), urethral catheterization (OR = 7.38, 95%CI 1.21−45.11, p = .030) and use of aminoglycosides (OR = 10.59, 95%CI 1.14−98.13, p = .038). Approximately 41% of P. aeruginosa isolates were resistant to imipenem, while 36.7% were multidrug-resistant. Mortality was similar in both groups: 54(60%) cases and 51(56.7%) controls; p = .650. Conclusions: The study identifies several potentially modifiable factors associated with P. aeruginosa infection in ICUs. Identification of these factors could facilitate case identification and enhance control measures.http://www.sciencedirect.com/science/article/pii/S1876034120307498Pseudomonas aeruginosaInfectionRisk factorsResistanceIntensive care unit |