[Risk factors and clinical outcomes of nosocomial infections caused by multidrug resistant Pseudomonas aeruginosa]

Abstract

Objective: To investigate the risk factors for multi-drug resistant Pseudomonas aeruginosa (MDRP) infections, and the factors related with poor prognosis of P. aeruginosa infections.

Methods: The data of 44 cases of MDRP nosocomial infections were analyzed from Jan, 1999. to Dec, 2002 in Peking Union Medical Hospital; 68 cases of antibiotic-sensitive P. aeuroginosa infection were randomized as control. T test, chi-square test and Logistic regression analysis were used for statistics.

Results: According to univariate analysis, the factors associated with the development of MDRP nosocomial infection were age, APACHE II, co-infection with other pathogens, hospital acquired pneumonia (HAP), mechanical ventilation, COPD, fluoroquinolone and imipenem/meropenem use 15 days before isolation of MDRP. Multivariate logistic regression analysis identified two independent factors: mechanical ventilation and previous imipenem/meropenem use. Of 44 cases of MDRP infections, 24 died, and 20 survived. Univariate analysis revealed that three factors (APACHE II, mechanical ventilation, resistance switch) were associated with clinical prognosis. But a ccording to multivariate logistic regression analysis, only resistance switch was a predictive factor.

Conclusions: Mechanical ventilation and previous imipenem/meropenem use were independent risk factors for MDRP infection. Resistance switch was a predictive factor for the prognosis of MDRP infection.