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Mortality of COPD patients infected with multi-resistant Pseudomonas aeruginosa: a case and control study

M Montero1, M Domínguez, M Orozco-Levi

  • 1Department of Internal Medicine and Infectious Diseases, Hospital del Mar, Autonomous University of Barcelona, Paseo Marítimo 25-29, 08003, Barcelona, Spain. 95422@imas.imim.es

Infection
|January 14, 2009
PubMed
Abstract

Insights

Multiresistant Pseudomonas aeruginosa (MDRP) infections in patients with chronic obstructive pulmonary disease (COPD) general ward admissions are linked to significantly higher mortality. This study highlights the poor prognosis associated with MDRP in this vulnerable patient group.

Area of Science:

  • Infectious Diseases
  • Pulmonology
  • Critical Care Medicine

Background:

  • The incidence of infections caused by multiresistant Pseudomonas aeruginosa (MDRP) is rising, particularly in critically ill patients.
  • The prognostic impact of MDRP in patients with chronic obstructive pulmonary disease (COPD) admitted to general wards is not well understood.

Purpose of the Study:

  • To investigate the association between MDRP infection and mortality in patients hospitalized for COPD acute exacerbation on general wards.

Main Methods:

  • A case-control study design was employed, including patients with MDRP isolated from sputum (cases) and matched controls without MDRP.
  • Exclusion criteria included recent ICU admission, surgery, neoplasia, or immunosuppressive treatment.
  • Patients were matched 1:1 for age, sex, admission date, and airway obstruction severity.

Main Results:

  • The study included 50 cases and 50 controls between 2000 and 2005.
  • Crude mortality at two years was 60% in the MDRP group versus 28% in the control group.
  • Adjusted logistic regression revealed MDRP infection was significantly associated with increased mortality (OR = 6.2; 95% CI: 1.7-22.1; p < 0.01).

Conclusions:

  • Acute exacerbation of COPD in general ward patients with MDRP in sputum is associated with a higher mortality rate.
  • MDRP poses a significant threat to COPD patients outside of intensive care settings.

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