scholarly journals Risk factors of nosocomial infections caused by piperacillin-tazobactam resistant Pseudomonas aeruginosa

2013 ◽  
Vol 141 (9-10) ◽  
pp. 640-647 ◽  
Author(s):  
Zorana Djordjevic ◽  
Olgica Gajovic ◽  
Zeljko Mijailovic ◽  
Aleksandra Ilic ◽  
Radojica Stolic
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Nosocomial Infections ◽  
Hospitalized Patients ◽  
Serious Infections ◽  
Clinical Centre ◽  
Independent Risk Factors ◽  
Hospital Morbidity ◽  
Tract Infections ◽  
Control Study

Introduction. Pseudomonas aeruginosa is a common cause of serious infections in hospitalized patients and is associated with high rates of hospital morbidity and mortality. Objective. The aim of this study was to identify the risk factors of nosocomial infections caused by piperacillin?tazobactam? resistant P. aeruginosa (PT?RPA). Methods. A case?control study was conducted in the Clinical Centre Kragujevac from January 2010 to December 2011. Results. In the observed period, 79 (38.16%) patients had PT? RPA infections, while 128 (61.84%) patients had infections caused by piperacillin?tazobactam?sensitive P. aeruginosa (PT?SPA). Pneumonia was more frequently found in the PT?RPA group (55.70%) (p<0.05), whereas urinary tract infections were more frequent in the group of patients with PT?SPA infections (26.56%) (p<0.01). Multivariate analysis was used to identify an injury on admission (OR=3.089; 95%CI=1.438?6.635; p=0.004), administration of imipenem (OR=15.027; 95%CI=1.778? 127.021; p=0.013), meropenem (OR=2.618; 95%CI=1.030? 6.653; p=0.043), ciprofloxacin (OR=3.380; 95%CI=1.412?8.090; p=0.006), vancomycin (OR=4.294; 95%CI=1.477?12.479; p=0.007), piperacillin?tazobactam (OR=4.047; 95%CI=1.395?11.742; p=0. 010) as independent risk factors associated with PT?RPA infection. Conclusion. In hospitalized patients, the risk of PT?RPA infections is associated with previous administration of imipenem, meropenem, ciprofloxacin, vancomycin, piperacillin?tazobactam, and the presence of injury on admission.

Nosocomial Infections With Ceftazidime-Resistant Pseudomonas aeruginosa: Risk Factors and Outcome

1999 ◽  
Vol 20 (03) ◽  
pp. 205-207 ◽  
Author(s):  
Sai-Cheong Lee ◽  
Chang-Phone Fung ◽  
Peter Yuk-Fong Liu ◽  
Tzu-Chien Wang ◽  
Lai-Chu See ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Logistic Regression ◽  
Prospective Studies ◽  
Nosocomial Infections ◽  
Gel Electrophoresis ◽  
Medical Personnel ◽  
Pulsed Field Gel Electrophoresis ◽  
Cross Infection ◽  
Independent Risk Factors

AbstractProspective studies were conducted for nosocomialPseudomonas aeruginosainfections from February 1, 1994, to October 30,1995. Of 97P aeruginosaisolates from 97 patients, 35 were resistant to ceftazidime. Logistic regression revealed previous cephalosporin or piperacillin use as independent risk factors for nosocomial ceftazidime-resistantP aeruginosainfection. Pulsed-field gel electrophoresis revealed that four nosocomial ceftazidime-resistantP aeruginosainfections were caused by cross-infection, probably through medical personnel.

scholarly journals Risk Factors for Piperacillin-Tazobactam-Resistant Pseudomonas aeruginosa among Hospitalized Patients

2002 ◽  
Vol 46 (3) ◽  
pp. 854-858 ◽  
Author(s):  
Anthony D. Harris ◽  
Eli Perencevich ◽  
Mary-Claire Roghmann ◽  
Glenn Morris ◽  
Keith S. Kaye ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Drug Exposure ◽  
Case Control Study ◽  
Hospitalized Patients ◽  
Comorbid Conditions ◽  
Surgical Services ◽  
Multivariable Analyses ◽  
Control Study ◽  
Multiple Antibiotics

ABSTRACT Antimicrobial resistance is an emerging problem with Pseudomonas aeruginosa. This study determined risk factors for the recovery of piperacillin-tazobactam-resistant P. aeruginosa from clinical cultures from hospitalized patients. A case-control study design was used to compare two groups of case patients with control patients. The first group of case patients was defined by nosocomial isolation of piperacillin-tazobactam-resistant P. aeruginosa, and the second group of cases yielded piperacillin-tazobactam-susceptible P. aeruginosa. Controls were selected in a 6:1 ratio from the same medical or surgical services among which piperacillin-tazobactam-resistant P. aeruginosa arose in patients. Risk factors analyzed included antimicrobial drug exposure, comorbid conditions, and demographics. Bivariate and multivariable analyses were performed. Piperacillin-tazobactam-resistant P. aeruginosa was isolated from 179 patients, and piperacillin-tazobactam-susceptible P. aeruginosa was isolated from 624 patients over a 2.5-year period. Piperacillin-tazobactam (odds ratio [OR] = 6.82; 95% confidence interval [CI], 4.56 to 10.21), imipenem (OR = 2.42; 95% CI, 1.19 to 4.94), aminoglycosides (OR = 2.18; 95% CI, 1.44 to 3.28), vancomycin (OR = 1.87; 95% CI, 1.21 to 2.89), and broad-spectrum cephalosporins (OR = 2.38; 95% CI, 1.45 to 3.88) were the antibiotics associated with the isolation of piperacillin-tazobactam-resistant P. aeruginosa. Exposure to vancomycin (OR = 1.53; 95% CI, 1.13 to 2.06) or ampicillin-sulbactam (OR = 2.28; 95% CI, 1.62 to 3.21) was associated with recovery of piperacillin-tazobactam-susceptible P. aeruginosa. In this study, antibiotics associated with piperacillin-tazobactam-susceptible P. aeruginosa were different from antibiotics associated with piperacillin-tazobactam-resistant P. aeruginosa. Piperacillin-tazobactam was a strong risk factor for piperacillin-tazobactam-resistant P. aeruginosa. Our results suggest that the nosocomial isolation of piperacillin-tazobactam-resistant P. aeruginosa may be affected by multiple antibiotics.

scholarly journals Evaluation of Risk Factors for Antibiotic Resistance in Patients with Nosocomial Infections Caused byPseudomonas aeruginosa

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Meliha Cagla Sonmezer ◽  
Gunay Ertem ◽  
Fatma Sebnem Erdinc ◽  
Esra Kaya Kilic ◽  
Necla Tulek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nosocomial Infection ◽  
Nosocomial Infections ◽  
Univariate Analysis ◽  
High Morbidity ◽  
Retrospective Case ◽  
Development Of Resistance ◽  
Independent Risk Factors ◽  
Imipenem Resistance ◽  
Control Study

Background.Pseudomonas aeruginosa(P. aeruginosa) is resistant to various antibiotics and can cause serious nosocomial infections with high morbidity and mortality. In this clinical study, we investigated the risk factors in patients who were diagnosed withP. aeruginosa-related nosocomial infection.Methods. A retrospective case control study including patients withP. aeruginosa-related nosocomial infection. Patients who were resistant to any of the six antibiotics (imipenem, meropenem, piperacillin-tazobactam, ciprofloxacin, amikacin, and ceftazidime) constituted the study group.Results. One hundred and twenty isolates were isolated. Various risk factors were detected for each antibiotic in the univariate analysis. In the multivariate analysis, previous cefazolin use was found as an independent risk factor for the development of imipenem resistance (OR = 3.33; CI 95% [1.11–10.0];p= 0.03), whereas previous cerebrovascular attack (OR = 3.57; CI 95% [1.31–9.76];p= 0.01) and previous meropenem use (OR = 4.13; CI 95% [1.21–14.07];p= 0.02) were independent factors for the development of meropenem resistance. For the development of resistance to ciprofloxacin, hospitalization in the neurology intensive care unit (OR = 4.24; CI 95% [1.5–11.98];p= 0.006) and mechanical ventilator application (OR = 11.7; CI 95% [2.24–61.45];p= 0.004) were independent risk factors.Conclusion. The meticulous application of contact measures can decrease the rate of nosocomial infections.

Risk factors associated with anthrax in cattle on smallholdings

2011 ◽  
Vol 140 (10) ◽  
pp. 1888-1895 ◽  
Author(s):  
P. K. BISWAS ◽  
M. Z. ISLAM ◽  
S. K. SHIL ◽  
R. K. CHAKRABORTY ◽  
S. S. U. AHMED ◽  
...  
Keyword(s):  
Risk Factors ◽  
Eichhornia Crassipes ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Study Data ◽  
Matched Pair ◽  
Matched Pair Analysis ◽  
Independent Risk Factors ◽  
Pair Analysis ◽  
Control Study

SUMMARYUnprecedented high rates of anthrax outbreaks have been observed recently in cattle and humans in Bangladesh, with 607 human cases in 2010. By enrolling 15 case and 15 control cattle smallholdings in the spatial zone in July–September 2010, we conducted a case-control study, data of which were analysed by matched-pair analysis and multivariable conditional logistic regression. Feeding animals with uprooted and unwashed grass [odds ratio (OR) 41·2, 95% confidence interval (CI) 3·7–458·8, P=0·003], and feeding water hyacinth (Eichhornia crassipes) (OR 22·2, 95% CI 1·2–418·7, P=0·039) were independent risk factors for anthrax in cattle.

Impact of the Bag Exchange Procedure on Risk of Peritonitis

2010 ◽  
Vol 30 (4) ◽  
pp. 440-447 ◽  
Author(s):  
Jie Dong ◽  
Yuan Chen
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Cox Regression ◽  
Face Mask ◽  
First Episode ◽  
Independent Risk Factors ◽  
Randomized Control ◽  
The Relationship ◽  
Control Study

ObjectiveWe studied whether improper bag exchange predicts the first peritonitis episode in continuous ambulatory peritoneal dialysis (CAPD) patients.Patients and MethodsOur single-center prospective observational study of 130 incident urban CAPD patients who started peritoneal dialysis (PD) between March 2005 and August 2008 aimed to determine the relationship between bag exchange procedures examined at the 6th month of PD and risk for a first peritonitis episode. All patients were followed until a first peritonitis episode, censoring, or the end of the study.ResultsThese 130 patients experienced 22 first peritonitis episodes during the 14-month follow-up. During bag exchange evaluation, 51.5% of patients washed their hands improperly, 46.2% failed to check expiration date or bag leakage, and 11.5% forgot to wear a face mask and cap. Patients experiencing peritonitis were more likely to forget to wear a face mask and cap. In multivariate Cox regression model, not wearing a face mask and cap [hazard ratio (HR): 7.26; 95% confidence interval (CI): 2.6 to 20.1; p < 0.001] and having anemia (HR: 0.96; 95% CI: 0.94 to 0.99; p = 0.005) were independent risk factors for a first episode of peritonitis.ConclusionsNot wearing a face mask and cap and having anemia were independent risk factors for peritonitis. A further randomized control study needs to verify the correlation between improper bag exchange technique and peritonitis in PD patients.

Carbapenem-ResistantKlebsiella pneumoniaein Post-Acute-Care Facilities in Israel

2011 ◽  
Vol 32 (9) ◽  
pp. 845-853 ◽  
Author(s):  
Debby Ben-David ◽  
Samira Masarwa ◽  
Shiri Navon-Venezia ◽  
Hagit Mishali ◽  
Ilan Fridental ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Care ◽  
Case Control Study ◽  
Case Control ◽  
Antibiotic Exposure ◽  
Care Facilities ◽  
History Of ◽  
Independent Risk Factors ◽  
Acute Care Facilities ◽  
Control Study

Objective.To assess the prevalence of and risk factors for carbapenem-resistantKlebsiella pneumoniae(CRKP) carriage among patients in post-acute-care facilities (PACFs) in Israel.Design, Setting, and Patients.A cross-sectional prevalence survey was conducted in 12 PACFs. Rectal swab samples were obtained from 1,144 patients in 33 wards. Risk factors for CRKP carriage were assessed among the cohort. Next, a nested, matched case-control study was conducted to define individual risk factors for colonization. Finally, the cohort of patients with a history of CRKP carriage was characterized to determine risk factors for continuous carriage.Results.The prevalence of rectal carriage of CRKP among 1,004 patients without a history of CRKP carriage was 12.0%. Independent risk factors for CRKP carriage were prolonged length of stay (odds ratio [OR], 1.001;P< .001), sharing a room with a known carrier (OR, 3.09;P= .02), and increased prevalence of known carriers on the ward (OR, 1.02;P= .013). A policy of screening for carriage on admission was protective (OR, 0.41;P= .03). Risk factors identified in the nested case-control study were antibiotic exposure during the prior 3 months (OR, 1.66;P= .03) and colonization with other resistant pathogens (OR, 1.64;P= .03). Among 140 patients with a history of CRKP carriage, 47% were colonized. Independent risk factors for continued CRKP carriage were antibiotic exposure during the prior 3 months (OR, 3.05;P= .04), receipt of amoxicillin-clavulanate (OR, 4.18;P= .007), and screening within 90 days of the first culture growing CRKP (OR, 2.9;P= .012).Conclusions.We found a large reservoir of CRKP in PACFs. Infection-control polices and antibiotic exposure were associated with patient colonization.

scholarly journals Diabetic Foot Infections: Local Prevalence of and Case–Control Study of Risk Factors for Methicillin-Resistant Staphylococcus aureus and Pseudomonas aeruginosa

2020 ◽  
Vol 7 (10) ◽  
Author(s):  
Justin J Kim ◽  
Alison Lydecker ◽  
Rohini Davé ◽  
Jacqueline T Bork ◽  
Mary-Claire Roghmann
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Diabetic Foot ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Case Control Study ◽  
Case Control ◽  
Methicillin Resistant ◽  
Diabetic Foot Infections ◽  
Control Study

Abstract We identified deep diabetic foot infections by culture and conducted a case–control study examining the risk factors for moderate to severe methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PsA) diabetic foot infections. Our MRSA prevalence was lower than literature values; PsA was higher. Gangrene may be predictive of Pseudomonas infection.

Impact of Checkpoint Inhibitor Immunotherapy, Primarily Pembrolizumab, on Infection Risk in Patients With Advanced Lung Cancer: A Comparative Retrospective Cohort Study

2020 ◽  
Author(s):  
Alexandre E Malek ◽  
Melissa Khalil ◽  
Ray Hachem ◽  
Anne Marie Chaftari ◽  
Johny Fares ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Urinary Tract ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Checkpoint Inhibitor ◽  
Advanced Lung Cancer ◽  
Lung Cancer Patients ◽  
Independent Risk Factors ◽  
Tract Infections

Abstract Background Checkpoint inhibitor (CPI) immunotherapy has revolutionized cancer treatment. However, immune-related adverse events and the risk of infections are not well studied. To assess the infectious risk of CPIs, we evaluated the incidence of infections in lung cancer patients treated with CPIs plus conventional chemotherapy (CC) vs CC alone. Methods We performed a retrospective comparative study of patients with advanced non–small cell lung cancer who received CPIs combined with CC and those treated with CC alone at our institution during January 2016 to February 2019. We compared clinical characteristics, treatments, and outcomes including infection rate and mortality between the groups. Results We identified 123 patients for the CPI group and 147 patients for the control (CC) group. Eighteen patients (15%) in the CPI group and 33 patients (22%) in the control group developed infections (P = .1). Pneumonia was the most common infection encountered in both groups. Urinary tract infection was higher in the CC group (40%) than in the CPI group (9%) (P = .01). On multivariable analysis, chronic obstructive pulmonary disease (P = .024), prior use of corticosteroids (P = .021), and neutropenia (P &lt; .001) were independent risk factors for infection and severe infection requiring hospital admission. Chronic kidney disease (P = .02), prior cancer treatment (P = .023), and neutropenia (P &lt; .0001) were identified as independent risk factors for all-cause mortality. Conclusions Lung cancer patients treated with CPIs combined with CC have a comparable risk of infection to those treated with CC alone, although there is a trend towards fewer infections in those given CPIs, particularly when it comes to urinary tract infections.

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