Risk factors for carbapenem-resistant Pseudomonas aeruginosa infection or colonization in a Chinese teaching hospital

  • Di Zhang
  • Kai Cui Xi’an University of Posts and Telecommunications, Xi’an, China
  • Taotao Wang The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
  • Yuanyuan Shan The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
  • Haiyan Dong The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
  • Weiyi Feng The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
  • Chen Ma The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
  • Yalin Dong The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
Keywords: Pseudomonas aeruginosa, carbapenem resistantance, risk factors, mortality

Abstract

Introduction: Carbapenem-resistant Pseudomonas aeruginosa (CRPA) is rapidly emerging as a life-threatening nosocomial infection. In this study, we aimed to identify risk factors, especially antibiotic use and co-carriage with other bacteria for CRPA infection or colonization.

Methodology: A retrospective study was conducted in the First Affiliated Hospital of Xi’an Jiaotong University, which involved a cohort of patients with Pseudomonas aeruginosa infection or colonization from January 2014 to June 2016. Univariate analysis and multivariate analysis were performed to estimate the risk factors of CRPA occurrence.

Results: Eight hundred and eighty-eight patients were included in the study. More than 50% of the risk factors were associated with CRPA infection or colonization according to univariate analysis (P < 0.05), such as invasive procedures, co-carriage with Gram-negative pathogens, and prior treatment with some antibiotics. However, only prior exposure to carbapenems (OR: 8.005; CI:4.507-14.217, P<0.001), the days of carbapenems treatment (OR: 1.190; CI: 1.073-1.272; P < 0.001), and co-carriage with Escherichia coli (OR: 1.824; CI: 1.005-3.310, P = 0.048) were considered independent risk factors by multivariate analysis. A higher mortality was found among patients with CRPA infection or colonization (P < 0.05).

Conclusions: Risk factors for CRPA infection or colonization were prior exposure to carbapenems, the days of carbapenems treatment, and co-carriage with Escherichia coli. The prevalence of CRPA could be influenced by Gram-negative pathogens, especially in Escherichia coli, and it need more researches. Moreover, restrictions in the clinical use of carbapenems should be taken into account.

Author Biography

Yalin Dong, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China

Dong Ya-Lin, Ph.D. Professor

Director of Department of Science and Technology

The First Affiliated Hospital of Xi’an Jiangtong University

No. 277 Yanta West Road

Xi'an, 710061, P.R.China

Tel: 029-85323241

Fax: 029-85323240

Published
2018-08-31
How to Cite
1.
Zhang D, Cui K, Wang T, Shan Y, Dong H, Feng W, Ma C, Dong Y (2018) Risk factors for carbapenem-resistant Pseudomonas aeruginosa infection or colonization in a Chinese teaching hospital. J Infect Dev Ctries 12:642-648. doi: https://doi.org/10.3855/jidc.10150
Section
Original Articles