Abstract
IntroductionPseudomonas aeruginosa nosocomial pneumonia (Pa-NP) is associated with considerable morbidity, prolonged hospitalization, increased costs, and mortality.MethodsWe 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.ResultsOf 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.ConclusionsAmong 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.
Highlights
Pseudomonas aeruginosa nosocomial pneumonia (Pa-NP) is associated with considerable morbidity, prolonged hospitalization, increased costs, and mortality
The mortality associated with Pa-NP is further increased when inappropriate initial antibiotic therapy (IIAT) is prescribed, usually due to the presence of MDR pathogens [10,11,12,13]
We performed a multinational study with the following objectives: first, to evaluate the prevalence of MDR P. aeruginosa (MDR Pa)-NP and to identify clinical risk factors associated with MDR Pa-NP; Micek et al Critical Care (2015) 19:219 second, to evaluate the influence of MDR status on patient outcomes
Summary
Pseudomonas aeruginosa nosocomial pneumonia (Pa-NP) is associated with considerable morbidity, prolonged hospitalization, increased costs, and mortality. Nosocomial pneumonia due to P. aeruginosa (Pa-NP) is associated with considerable morbidity, prolonged hospitalization, increased costs, and mortality [6,7,8]. The mortality associated with Pa-NP is further increased when inappropriate initial antibiotic therapy (IIAT) is prescribed, usually due to the presence of MDR pathogens [10,11,12,13]. We performed a multinational study with the following objectives: first, to evaluate the prevalence of MDR Pa-NP and to identify clinical risk factors associated with MDR Pa-NP; Micek et al Critical Care (2015) 19:219 second, to evaluate the influence of MDR status on patient outcomes
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
