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Risk Factors and Outcomes for Multidrug Resistant Pseudomonas aeruginosa Infection in Immunocompromised Patients

Background: Pseudomonas aeruginosa (PSA) infection often occurs in immunocompromised patients, which also face an increased risk of multidrug-resistant (MDR) bacteria. A deeper knowledge of the risk factors for MDR-PSA infection in this patient population may help to choose appropriate empirical ant...

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Autores principales: Hernández-Jiménez, Pilar, López-Medrano, Francisco, Fernández-Ruiz, Mario, Silva, J. Tiago, Corbella, Laura, San-Juan, Rafael, Lizasoain, Manuel, Díaz-Regañón, Jazmín, Viedma, Esther, Aguado, José María
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9686626/
https://www.ncbi.nlm.nih.gov/pubmed/36358114
http://dx.doi.org/10.3390/antibiotics11111459
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author Hernández-Jiménez, Pilar
López-Medrano, Francisco
Fernández-Ruiz, Mario
Silva, J. Tiago
Corbella, Laura
San-Juan, Rafael
Lizasoain, Manuel
Díaz-Regañón, Jazmín
Viedma, Esther
Aguado, José María
author_facet Hernández-Jiménez, Pilar
López-Medrano, Francisco
Fernández-Ruiz, Mario
Silva, J. Tiago
Corbella, Laura
San-Juan, Rafael
Lizasoain, Manuel
Díaz-Regañón, Jazmín
Viedma, Esther
Aguado, José María
author_sort Hernández-Jiménez, Pilar
collection PubMed
description Background: Pseudomonas aeruginosa (PSA) infection often occurs in immunocompromised patients, which also face an increased risk of multidrug-resistant (MDR) bacteria. A deeper knowledge of the risk factors for MDR-PSA infection in this patient population may help to choose appropriate empirical antibiotic therapy. Methods: a single-center case-control (1:2) retrospective study that included 48 patients with underlying immunosuppression developing MDR-PSA infection (cases) and 96 patients also immunocompromised that were infected with non-MDR-PSA (controls) was conducted. Both groups were matched by site of infection, clinical features and type of immunosuppression. Risk factors for MDR-PSA were assessed by logistic regression. Clinical outcomes were also compared between both groups. Results: immunosuppression was due to solid cancer in 63 (43.8%) patients, solid organ transplantation in 39 (27.1%), hematological disease in 35 (24.3%) and other causes in 7 (4.9%). Independent risk factors for MDR-PSA infection were diabetes mellitus (odds ratio [OR]: 4.74; 95% confidence interval [CI]: 1.63–13.79; p = 0.004), antibiotic therapy in the previous 3 months (OR: 5.32; 95% CI: 1.93–14.73; p = 0.001), previous MDR-PSA colonization (OR: 42.1; 95% CI: 4.49–394.8; p = 0.001) and septic shock (OR: 3.73; 95% CI: 1.36–10.21; p = 0.010). MDR-PSA cases were less likely to receive adequate empirical therapy (14 [29.2%] vs. 69 [71.9%]; p < 0.001). 30-day clinical improvement was less common in MDR-PSA cases (25 [52.1%] vs. 76 [79.2%]; p = 0.001). Conclusions: diabetes mellitus, previous MDR-PSA colonization, prior receipt of antibiotics and septic shock acted as risk factors for developing MDR-PSA infections in immunocompromised patients, who have a poorer outcome than those infected with non-MDR-PSA strains.
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spelling pubmed-96866262022-11-25 Risk Factors and Outcomes for Multidrug Resistant Pseudomonas aeruginosa Infection in Immunocompromised Patients Hernández-Jiménez, Pilar López-Medrano, Francisco Fernández-Ruiz, Mario Silva, J. Tiago Corbella, Laura San-Juan, Rafael Lizasoain, Manuel Díaz-Regañón, Jazmín Viedma, Esther Aguado, José María Antibiotics (Basel) Article Background: Pseudomonas aeruginosa (PSA) infection often occurs in immunocompromised patients, which also face an increased risk of multidrug-resistant (MDR) bacteria. A deeper knowledge of the risk factors for MDR-PSA infection in this patient population may help to choose appropriate empirical antibiotic therapy. Methods: a single-center case-control (1:2) retrospective study that included 48 patients with underlying immunosuppression developing MDR-PSA infection (cases) and 96 patients also immunocompromised that were infected with non-MDR-PSA (controls) was conducted. Both groups were matched by site of infection, clinical features and type of immunosuppression. Risk factors for MDR-PSA were assessed by logistic regression. Clinical outcomes were also compared between both groups. Results: immunosuppression was due to solid cancer in 63 (43.8%) patients, solid organ transplantation in 39 (27.1%), hematological disease in 35 (24.3%) and other causes in 7 (4.9%). Independent risk factors for MDR-PSA infection were diabetes mellitus (odds ratio [OR]: 4.74; 95% confidence interval [CI]: 1.63–13.79; p = 0.004), antibiotic therapy in the previous 3 months (OR: 5.32; 95% CI: 1.93–14.73; p = 0.001), previous MDR-PSA colonization (OR: 42.1; 95% CI: 4.49–394.8; p = 0.001) and septic shock (OR: 3.73; 95% CI: 1.36–10.21; p = 0.010). MDR-PSA cases were less likely to receive adequate empirical therapy (14 [29.2%] vs. 69 [71.9%]; p < 0.001). 30-day clinical improvement was less common in MDR-PSA cases (25 [52.1%] vs. 76 [79.2%]; p = 0.001). Conclusions: diabetes mellitus, previous MDR-PSA colonization, prior receipt of antibiotics and septic shock acted as risk factors for developing MDR-PSA infections in immunocompromised patients, who have a poorer outcome than those infected with non-MDR-PSA strains. MDPI 2022-10-23 /pmc/articles/PMC9686626/ /pubmed/36358114 http://dx.doi.org/10.3390/antibiotics11111459 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hernández-Jiménez, Pilar
López-Medrano, Francisco
Fernández-Ruiz, Mario
Silva, J. Tiago
Corbella, Laura
San-Juan, Rafael
Lizasoain, Manuel
Díaz-Regañón, Jazmín
Viedma, Esther
Aguado, José María
Risk Factors and Outcomes for Multidrug Resistant Pseudomonas aeruginosa Infection in Immunocompromised Patients
title Risk Factors and Outcomes for Multidrug Resistant Pseudomonas aeruginosa Infection in Immunocompromised Patients
title_full Risk Factors and Outcomes for Multidrug Resistant Pseudomonas aeruginosa Infection in Immunocompromised Patients
title_fullStr Risk Factors and Outcomes for Multidrug Resistant Pseudomonas aeruginosa Infection in Immunocompromised Patients
title_full_unstemmed Risk Factors and Outcomes for Multidrug Resistant Pseudomonas aeruginosa Infection in Immunocompromised Patients
title_short Risk Factors and Outcomes for Multidrug Resistant Pseudomonas aeruginosa Infection in Immunocompromised Patients
title_sort risk factors and outcomes for multidrug resistant pseudomonas aeruginosa infection in immunocompromised patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9686626/
https://www.ncbi.nlm.nih.gov/pubmed/36358114
http://dx.doi.org/10.3390/antibiotics11111459
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