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Risk factors for multidrug-resistant Pseudomonas aeruginosa nosocomial infection

C Defez1, P Fabbro-Peray, N Bouziges

  • 1Service de Bactériologie, Virologie, Parasitologie, CHU Nîmes, France.

The Journal of Hospital Infection
|July 9, 2004
PubMed

Insights

Nasogastric feeding and urinary catheterization are key risk factors for multidrug-resistant Pseudomonas aeruginosa (MDR-PA) infections in hospitals. Antibiotic exposure also contributes to MDR-PA development, highlighting the need for targeted prevention strategies.

Area of Science:

  • Infectious Diseases
  • Hospital Epidemiology
  • Antimicrobial Resistance

Background:

  • Nosocomial infections, particularly those caused by multidrug-resistant pathogens like Pseudomonas aeruginosa (MDR-PA), pose a significant threat to patient safety and healthcare costs.
  • Identifying specific risk factors for MDR-PA is crucial for developing effective infection control and prevention strategies within hospital settings.

Purpose of the Study:

  • To investigate the risk factors associated with nosocomial infections caused by multidrug-resistant Pseudomonas aeruginosa (MDR-PA) among hospitalized patients.
  • To differentiate risk factors for MDR-PA acquisition among all hospitalized patients versus those already infected with P. aeruginosa.

Main Methods:

  • A case-control study was conducted over 12 months at a university hospital.
  • Included were 80 patients with MDR-PA, 75 with non-MDR P. aeruginosa, and 240 random controls.
  • Data collected included patient demographics, clinical conditions, and recent antibiotic exposures.

Main Results:

  • Among all hospitalized patients, age, bedridden status, nasogastric feeding, urinary catheterization, and prior exposure to beta-lactams or fluoroquinolones were associated with MDR-PA infection.
  • In patients with P. aeruginosa infection, fluoroquinolone exposure (OR=4.7) was linked to MDR-PA, while surgery (OR=0.5) showed a protective association.
  • Nasogastric feeding emerged as a significant risk factor, alongside urinary catheterization, for MDR-PA.

Conclusions:

  • Nasogastric feeding, in addition to urinary catheterization, represents a critical risk factor for MDR-PA infections.
  • Factors such as gut flora imbalance and mucosal changes induced by nasogastric feeding, coupled with antibiotic selection pressure, contribute to MDR-PA occurrence.
  • Findings underscore the importance of considering these factors in infection control protocols for MDR-PA.

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