Related Experiment Video
Updated: Sep 4, 2025
Following in Real Time the Impact of Pneumococcal Virulence Factors in an Acute Mouse Pneumonia Model Using Bioluminescent Bacteria
Published on: February 23, 2014
Clinical risk factors for admission with Pseudomonas and multidrug-resistant Pseudomonas community-acquired pneumonia
Adeniyi J Idigo1, J Michael Wells2,3,4, Matthew L Brown5
1Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, Alabama, 35233, USA. jerryidigo@gmail.com.
Background:
Microbial etiology for community-acquired pneumonia (CAP) is evolving with pathogens known for high CAP mortality e.g., Pseudomonas species. Chronic obstructive pulmonary disease (COPD) patients are at risk for hospitalization for CAP. Understanding regional patterns and risk factors for multidrug-resistant (MDR) Pseudomonas acquisition has implications for antimicrobial stewardship.
Objectives:
To evaluate the regional epidemiology of MDR Pseudomonas CAP and its association with COPD.
Methods:
We queried the electronic medical records of the University of Alabama at Birmingham Healthcare System to identify patients hospitalized for CAP with Pseudomonas positive respiratory samples between 01/01/2013-12/31/2019. Log binomial regression models were used to examine associations between COPD diagnosis and risk of Pseudomonas/MDR Pseudomonas CAP.
Results:
Cohort consisted of 913 culture positive CAP cases aged 59-year (IQR:48-68), 61% (560) male, 60% (547) white, 65% (580) current/past smokers, and 42% (384) COPD. Prevalence of Pseudomonas CAP in culture positive CAP was 18% (167), MDR Pseudomonas CAP in Pseudomonas CAP was 22% (36), and yearly incidence of MDR Pseudomonas CAP was stable (p = 0.169). COPD was associated with Pseudomonas CAP (RR 1.39; 95% CI 1.01, 1.91; p = 0.041) but not with MDR Pseudomonas CAP (0.71; 95% CI 0.35, 1.45; p = 0.349). Stroke (RR 2.64; 95% CI 1.51, 4.61; p = 0.0006) and use of supplemental oxygen (RR 2.31; 95% CI 1.30, 4.12; p = 0.005) were associated with MDR Pseudomonas CAP.
Conclusion:
Incidence of MDR Pseudomonas CAP was stable over time. COPD was associated with Pseudomonas CAP but not with MDR Pseudomonas CAP. Larger cohort studies are needed to confirm findings.
Insights
Chronic obstructive pulmonary disease (COPD) patients with Pseudomonas community-acquired pneumonia (CAP) were not at higher risk for multidrug-resistant (MDR) strains. Stroke and oxygen use were linked to MDR Pseudomonas CAP.
Area of Science:
- Infectious Diseases
- Pulmonology
- Epidemiology
Background:
- The microbial causes of community-acquired pneumonia (CAP) are changing, with Pseudomonas species identified as a significant cause of mortality.
- Patients with chronic obstructive pulmonary disease (COPD) face an increased risk of hospitalization due to CAP.
- Understanding the geographic distribution and risk factors for multidrug-resistant (MDR) Pseudomonas acquisition is crucial for effective antimicrobial stewardship.
Purpose of the Study:
- To investigate the regional epidemiology of MDR Pseudomonas CAP.
- To determine the association between COPD and the risk of developing MDR Pseudomonas CAP.
Main Methods:
- A retrospective analysis of electronic medical records from the University of Alabama at Birmingham Healthcare System was conducted.
- Patients hospitalized for CAP with Pseudomonas-positive respiratory samples between 2013 and 2019 were identified.
- Log binomial regression models were employed to assess the relationship between COPD and the risk of Pseudomonas and MDR Pseudomonas CAP.
Main Results:
- The study included 913 patients with culture-positive CAP; 42% had a COPD diagnosis.
- Pseudomonas CAP prevalence was 18%, and MDR Pseudomonas CAP prevalence within Pseudomonas CAP cases was 22%.
- COPD was associated with an increased risk of Pseudomonas CAP (RR 1.39) but not MDR Pseudomonas CAP (RR 0.71). Stroke and supplemental oxygen use were significantly associated with MDR Pseudomonas CAP.
Conclusions:
- The incidence of MDR Pseudomonas CAP remained stable throughout the study period.
- While COPD was linked to Pseudomonas CAP, it was not a significant risk factor for MDR Pseudomonas CAP.
- Further extensive cohort studies are recommended to validate these findings.
Related Concept Videos
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:30Pneumonia III: Complications and Assessment
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:28Acute Pyelonephritis II: Diagnostic Studies and Management