Abstract
OBJECTIVES: To assess risk factors for nosocomial infections due to Pseudomonas aeruginosa producing metallo-beta-lactamase (MBL-PA) in two teaching hospitals where horizontal dissemination has been demonstrated. METHODS: A case-control study was performed in both hospitals (assigned as hospital 1 and 2). Cases were patients with MBL-PA infections and controls were those with non-MBL-PA infections. Multivariate analysis was performed to identify independent risk factors. RESULTS: A total of 86 cases and 212 controls were included in the study. A logistic regression model showed that exposure to beta-lactams odds ratio (OR) 3.21; 95\% confidence interval (CI) 1.74-5.93 or fluoroquinolones (OR 3.50; 95\% CI 1.46-8.37) was associated with MBL-PA infections. Other independent risk factors were neurological disease (OR 3.00; 95\% CI 1.61-5.58), urinary tract infection (OR 2.48; 95\% CI 1.21-5.09) and renal failure (OR 2.29; 95\% CI 1.13-4.65). Admission to hospital 1 (OR 5.97; 95\% CI 3.45-14.09) and intensive care unit stay (OR 2.07; 95\% CI 1.46-3.96) were also associated with increased risk for MBL-PA infections. CONCLUSIONS: beta-Lactam exposure is an important risk factor for MBL-PA infections even in a setting where patient-to-patient transmission plays a major role in the spread of the isolates. Other risk factors deserve further investigation, particularly exposure to fluoroquinolones.
- adult,
- aeruginosa,
- aged,
- agents,
- cross
- factors
- female,
- fluoroquinolones,
- hospitals,
- humans,
- incidence,
- infection,
- infections,
- male,
- middle
- pseudomonas
- risk
- studies,
- teaching,
- {anti-bacterial}
- {beta-lactamases,}
- {beta-lactams,}
- {case-control}
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