Title |
An international multicenter retrospective study of Pseudomonas aeruginosa nosocomial pneumonia: impact of multidrug resistance
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Published in |
Critical Care, December 2015
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DOI | 10.1186/s13054-015-0926-5 |
Pubmed ID | |
Authors |
Scott T Micek, Richard G Wunderink, Marin H Kollef, Catherine Chen, Jordi Rello, Jean Chastre, Massimo Antonelli, Tobias Welte, Bernard Clair, Helmut Ostermann, Esther Calbo, Antoni Torres, Francesco Menichetti, Garrett E Schramm, Vandana Menon |
Abstract |
Pseudomonas aeruginosa nosocomial pneumonia (Pa-NP) is associated with considerable morbidity, prolonged hospitalization, increased costs, and mortality. We conducted a retrospective cohort study of adult patients with Pa-NP to determine 1) risk factors for multidrug-resistant (MDR) strains and 2) whether MDR increases the risk for hospital death. Twelve hospitals in 5 countries (United States, n = 3; France, n = 2; Germany, n = 2; Italy, n = 2; and Spain, n = 3) participated. We compared characteristics of patients who had MDR strains to those who did not and derived regression models to identify predictors of MDR and hospital mortality. Of 740 patients with Pa-NP, 226 patients (30.5%) were infected with MDR strains. In multivariable analyses, independent predictors of multidrug-resistance included decreasing age (adjusted odds ratio [AOR] 0.91, 95% confidence interval [CI] 0.96-0.98), diabetes mellitus (AOR 1.90, 95% CI 1.21-3.00) and ICU admission (AOR 1.73, 95% CI 1.06-2.81). Multidrug-resistance, heart failure, increasing age, mechanical ventilation, and bacteremia were independently associated with in-hospital mortality in the Cox Proportional Hazards Model analysis. Among patients with Pa-NP the presence of infection with a MDR strain is associated with increased in-hospital mortality. Identification of patients at risk of MDR Pa-NP could facilitate appropriate empiric antibiotic decisions that in turn could lead to improved hospital survival. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Puerto Rico | 2 | 40% |
United Kingdom | 1 | 20% |
France | 1 | 20% |
Unknown | 1 | 20% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Practitioners (doctors, other healthcare professionals) | 3 | 60% |
Members of the public | 2 | 40% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Brazil | 2 | <1% |
Portugal | 1 | <1% |
Mozambique | 1 | <1% |
India | 1 | <1% |
United Kingdom | 1 | <1% |
Spain | 1 | <1% |
United States | 1 | <1% |
Unknown | 208 | 96% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 32 | 15% |
Researcher | 27 | 13% |
Student > Ph. D. Student | 25 | 12% |
Student > Bachelor | 24 | 11% |
Other | 17 | 8% |
Other | 40 | 19% |
Unknown | 51 | 24% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 58 | 27% |
Agricultural and Biological Sciences | 23 | 11% |
Biochemistry, Genetics and Molecular Biology | 21 | 10% |
Immunology and Microbiology | 15 | 7% |
Pharmacology, Toxicology and Pharmaceutical Science | 15 | 7% |
Other | 23 | 11% |
Unknown | 61 | 28% |