Risk factors for Pseudomonas aeruginosa VIM colonization or infection in the ICU: Case-control study
Charbel Assaad1, Khalil Chaibi2, Françoise Jaureguy1
1Unité de Prévention du Risque Infectieux, Département de Microbiologie Clinique, Groupe Hospitalier Paris Seine Saint-Denis, Université Paris 13, Bobigny, France.
Background:
Carbapenem-resistant strains of Pseudomonas aeruginosa (CRPA) have become a major health care concern in many countries, against which anti-infective strategies are limited and which require adequate infection control interventions. Knowing the different modes of transmission of CRPA in intensive care units (ICUs) would be helpful to adapt the means of prevention.
Methods:
The aim of this retrospective case-control study was conducted between January 1, 2017 and February 28, 2022 to identify the risk factors for the acquisition of CRPA in ICUs.
Results:
During the study period, 147 patients were included (49 cases and 98 controls). Among the 49 patients, 31 (63%) acquired CRPA in clusters and 18 (37%) sporadically. A univariate analysis showed that 4 variables were associated with CRPA acquisition, including (1) prior antibiotic prescriptions, (2) admission to rooms 203 and 207, (3) severity of illness at admission, and (4) use of mechanical ventilation. Multivariate analysis identified 3 factors of CRPA acquisition, including admission to room 203 (odds ratio [OR] = 29.5 [3.52-247.09]), previous antibiotic therapy (OR = 3.44 [1.02-11.76]), and severity of condition at admission (OR = 1.02 [1-1.04]).
Conclusions:
Our study suggests the role of a contaminated environment in the acquisition of CRPA in the ICU, along with antibiotic use.
Insights
Carbapenem-resistant Pseudomonas aeruginosa (CRPA) acquisition in ICUs is linked to environmental contamination and prior antibiotic use. Targeted interventions are crucial for preventing CRPA transmission in healthcare settings.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Public Health
Background:
- Carbapenem-resistant Pseudomonas aeruginosa (CRPA) presents a significant healthcare challenge due to limited treatment options.
- Effective infection control strategies are essential in intensive care units (ICUs) to mitigate CRPA transmission.
Purpose of the Study:
- To identify risk factors associated with the acquisition of CRPA in ICU patients.
- To inform the development of targeted prevention and control measures for CRPA in healthcare settings.
Main Methods:
- A retrospective case-control study was conducted from January 2017 to February 2022.
- 147 patients (49 cases, 98 controls) were analyzed to determine factors contributing to CRPA acquisition.
Main Results:
- Multivariate analysis revealed that admission to room 203 (OR=29.5), previous antibiotic therapy (OR=3.44), and severity of illness at admission (OR=1.02) were significant risk factors for CRPA acquisition.
- A substantial proportion of CRPA cases (63%) occurred in clusters.
Conclusions:
- The study highlights the role of environmental contamination and antibiotic use in CRPA acquisition within ICUs.
- Findings suggest that environmental cleaning protocols and judicious antibiotic stewardship are critical for controlling CRPA spread.
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