Epidemiology and risk factors of extensively drug-resistant Pseudomonas aeruginosa infections.
The incidence of nosocomial infections from extensively drug-resistant Pseudomonas aeruginosa (XDR-PA) has been increasing worldwide. We investigated the prevalence and factors associated with XDR-PA infections, including the factors that predict mortality.We retrospectively studied a cohort of adul...
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doaj-faa9ee8e760d421a8aaf308026fe5f982020-11-25T02:19:47ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01132e019343110.1371/journal.pone.0193431Epidemiology and risk factors of extensively drug-resistant Pseudomonas aeruginosa infections.Nattawan PalavutitotaiAnupop JitmuangSasima TongsaiPattarachai KiratisinNasikarn AngkasekwinaiThe incidence of nosocomial infections from extensively drug-resistant Pseudomonas aeruginosa (XDR-PA) has been increasing worldwide. We investigated the prevalence and factors associated with XDR-PA infections, including the factors that predict mortality.We retrospectively studied a cohort of adult, hospitalized patients with P. aeruginosa (PA) infections between April and December 2014.Of the 255 patients with PA infections, 56 (22%) were due to XDR-PA, 32 (12.5%) to multidrug resistant Pseudomonas aeruginosa (MDR-PA), and 167 (65.5%) to non-MDR PA. Receiving total parenteral nutrition (adjusted OR [aOR] 6.21; 95% CI 1.05-36.70), prior carbapenem use (aOR 4.88; 95% CI 2.36-10.08), and prior fluoroquinolone use (aOR 3.38; 95% CI 1.44-7.97) were independently associated with the XDR-PA infections. All XDR-PA remained susceptible to colistin. Factors associated with mortality attributable to the infections were the presence of sepsis/septic shock (aOR 11.60; 95% CI 4.66-28.82), admission to a medical department (aOR 4.67; 95% CI 1.81-12.06), receiving a central venous catheter (aOR 3.78; 95% CI 1.50-9.57), and XDR-PA infection (aOR 2.73; 95% CI 1.05-7.08).The prevalence of XDR-PA infections represented almost a quarter of Pseudomonas aeruginosa hospital-acquired infections and rendered a higher mortality. The prompt administration of an appropriate empirical antibiotic should be considered when an XDR-PA infection is suspected.http://europepmc.org/articles/PMC5823452?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Nattawan Palavutitotai Anupop Jitmuang Sasima Tongsai Pattarachai Kiratisin Nasikarn Angkasekwinai |
spellingShingle |
Nattawan Palavutitotai Anupop Jitmuang Sasima Tongsai Pattarachai Kiratisin Nasikarn Angkasekwinai Epidemiology and risk factors of extensively drug-resistant Pseudomonas aeruginosa infections. PLoS ONE |
author_facet |
Nattawan Palavutitotai Anupop Jitmuang Sasima Tongsai Pattarachai Kiratisin Nasikarn Angkasekwinai |
author_sort |
Nattawan Palavutitotai |
title |
Epidemiology and risk factors of extensively drug-resistant Pseudomonas aeruginosa infections. |
title_short |
Epidemiology and risk factors of extensively drug-resistant Pseudomonas aeruginosa infections. |
title_full |
Epidemiology and risk factors of extensively drug-resistant Pseudomonas aeruginosa infections. |
title_fullStr |
Epidemiology and risk factors of extensively drug-resistant Pseudomonas aeruginosa infections. |
title_full_unstemmed |
Epidemiology and risk factors of extensively drug-resistant Pseudomonas aeruginosa infections. |
title_sort |
epidemiology and risk factors of extensively drug-resistant pseudomonas aeruginosa infections. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2018-01-01 |
description |
The incidence of nosocomial infections from extensively drug-resistant Pseudomonas aeruginosa (XDR-PA) has been increasing worldwide. We investigated the prevalence and factors associated with XDR-PA infections, including the factors that predict mortality.We retrospectively studied a cohort of adult, hospitalized patients with P. aeruginosa (PA) infections between April and December 2014.Of the 255 patients with PA infections, 56 (22%) were due to XDR-PA, 32 (12.5%) to multidrug resistant Pseudomonas aeruginosa (MDR-PA), and 167 (65.5%) to non-MDR PA. Receiving total parenteral nutrition (adjusted OR [aOR] 6.21; 95% CI 1.05-36.70), prior carbapenem use (aOR 4.88; 95% CI 2.36-10.08), and prior fluoroquinolone use (aOR 3.38; 95% CI 1.44-7.97) were independently associated with the XDR-PA infections. All XDR-PA remained susceptible to colistin. Factors associated with mortality attributable to the infections were the presence of sepsis/septic shock (aOR 11.60; 95% CI 4.66-28.82), admission to a medical department (aOR 4.67; 95% CI 1.81-12.06), receiving a central venous catheter (aOR 3.78; 95% CI 1.50-9.57), and XDR-PA infection (aOR 2.73; 95% CI 1.05-7.08).The prevalence of XDR-PA infections represented almost a quarter of Pseudomonas aeruginosa hospital-acquired infections and rendered a higher mortality. The prompt administration of an appropriate empirical antibiotic should be considered when an XDR-PA infection is suspected. |
url |
http://europepmc.org/articles/PMC5823452?pdf=render |
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