Rev Esp Quimioter 2018; 31(2): 123-130.

Nosocomial infections caused by multiresistant Pseudomonas aeruginosa (carbapenems included): predictive and prognostic factors. A prospective study (2016-2017)

ALICIA HERNÁNDEZ, GENOVEVA YAGÜE, ELISA GARCÍA VÁZQUEZ, MARINA SIMÓN, LAURA MORENO PARRADO, MANUEL CANTERAS, JOAQUÍN GÓMEZ

Introduction. Pseudomonas aeruginosa is one of the major pathogens causing hospital-acquired infections. In recent years, antimicrobial resistance is increasing and multidrug resistant (MDR) and extremely drug resistant (XDR) isolates have been associated with an increase of mortality. The aim of this study is to assess the clinical significance and analyze predictors and prognostic factors.
Methods. Prospective case-control non-paired study involving 64 patients with P. aeruginosa nosocomial infection, 32 caused by susceptible P. aeruginosa and 32 by MDR/XDR including to carbapenems (XDR-C) strains, admitted at a third level hospital. The follow-up period was till hospital discharge or death and at 30 days after discharge. For all patients, clinical epidemiology and microbiological data were analyzed.
Results. The incidence of MDR/XDR-C strains was 2.3 per 1000 admissions. Ten of which were VIM metallo-β-lactamase–producing. Independent predictor factors associated with MDR/XDR-C infections were: previous ICU or Resuscitation unit admission (OR 14.01; IC 95% 2.105-93.297) appearance >20 days after admission (OR 29.826; IC 95% 4.783-185.997) and leukocytosis (OR 10.0190; IC 95% 1.842-56.369). However, there were not statistically significant differences in clinical severity or mortality between both groups.
Conclusión. The major risk factors associated with MDR/XDR-C infections were previous ICU or Resuscitation unit admission, appearance >20 days after admission and leukocytosis. MDR/XDR-C infections were not associated to increased mortality.

Rev Esp Quimioter 2018; 31(2): 123-130. [Texto completo PDF]