Factors associated with epidemic multiresistant Pseudomonas aeruginosa infections in a hospital with AIDS-predominant admissions

Braz J Infect Dis. 2012 May-Jun;16(3):219-25. doi: 10.1590/s1413-86702012000300001.

Abstract

Introduction: Infections caused by multiresistant Pseudomonas aeruginosa (MR-PA) have been associated with persistent infections and high mortality in acquired immunodeficiency syndrome (AIDS) patients. Therefore, understanding the predisposing factors for infection/colonization by this agent is critical for controlling outbreaks caused by MR-PA in settings with AIDS patients.

Objective and methods: To analyze the presence of factors associated with the acquisition of an epidemic MR-PA strain in a hospital with AIDS-predominant admission. A case-control study was carried out in which cases and controls were gathered from a prospective cohort of all hospitalized patients in an infectious disease hospital during a five-year study period.

Results: Multivariate logistic regression analysis demonstrated that enteral nutrition OR = 14.9), parenteral nutrition (OR = 10.7), and use of ciprofloxacin (OR = 8.9) were associated with a significant and independent risk for MR-PA acquisition.

Conclusions: Although cross-colonization was likely responsible for the outbreaks, the use of ciprofloxacin was also an important factor associated with the acquisition of an epidemic MR-PA strain. More studies are necessary to determine whether different types of nutrition could lead to modification of gastrointestinal flora, thereby increasing the risk for infection/colonization by MR-PA in this population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS-Related Opportunistic Infections / microbiology*
  • AIDS-Related Opportunistic Infections / mortality
  • Adult
  • Brazil / epidemiology
  • Cross Infection
  • Drug Resistance, Multiple, Bacterial*
  • Epidemics
  • Epidemiologic Methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pseudomonas Infections / microbiology*
  • Pseudomonas Infections / mortality
  • Pseudomonas aeruginosa*