Imipenem-Resistant Pseudomonas aeruginosa : Risk Factors for Nosocomial Infections

다국어 초록 (Multilingual Abstract)

The aim of this study was to determine the risk factors for nosocomial infections of

imipenem-resistant Pseudomonas aeruginosa (IRPA). A prospective case-control

study was performed at a tertiary care hospital in Ankara from January to December

2004. The patients with nosocomial P. aeruginosa infection were included in

the study. The features of the patients with IRPA infections were compared to those

with imipenem-sensitive P. aeruginosa (ISPA) infections. Only the first isolation of

P. aeruginosa was considered. Nosocomial infections were defined according to

Center for Disease Control (CDC) criteria. IRPA was isolated from 75 (44.1%)

patients, and ISPA was isolated from 95 (55.9%) patients during the study period.

IRPA were most frequently isolated from endotracheal aspirate (19%) cultures (p=

0.048), whereas ISPA were most frequently isolated from urine (28%) cultures (p=

0.023). In multivariate analysis, a longer duration of hospital stay until P. aeruginosa

isolation (odds ratio [OR], 1.027; 95% confidence interval [CI], 1.002-1.054, p=0.034),

arterial catheter administration (OR, 2.508; 95% CI, 1.062-5.920, p=0.036), vancomycin

(OR, 2.882; 95% CI, 1.130-7.349, p=0.027), piperacillin-tazobactam (OR,

6.425; 95% CI, 2.187-18.875, p=0.001), and imipenem (OR, 3.580; 95% CI, 1.252-

10.245, p=0.017) treatment within the 14 days before isolation of IRPA were independently

associated with imipenem resistance. It was concluded that treatment

with imipenem, vancomycin and piperacillin-tazobactam were major risk factors for

IRPA infections in hospitalized patients. The nosocomial occurrence of IRPA was

also strongly related to the duration of hospital stay, arterial catheter administration.

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