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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...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
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. |
format | Online Article Text |
id | pubmed-9686626 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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