Clinical and treatment-related risk factors for nosocomial colonisation with extensively drug-resistant Pseudomonas aeruginosa in a haematological patient population: a matched case control study

BMC Infectious Diseases

Michael Buhl¹  Silke Peter¹  Ingo B Autenrieth¹  Matthias Marschal¹  Jan Liese¹  Wichard Vogel²  Anna M Klimek¹  Matthias Willmann¹ 

[1] German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany;Medical Center, Department of Hematology, Oncology, Immunology, Rheumatology & Pulmonology, University of Tübingen, Tübingen, Germany

关键词: Conditional logistic regression;    Matched case–control study;    Clinical score construction;    Clinical risk score;    VIM carbapenemase;    IMP carbapenemase;    Predictors of colonisation;    XDR;   

Others  :  1118072
DOI  :  10.1186/s12879-014-0650-9

 received in 2014-10-05, accepted in 2014-11-21,  发布年份 2014

【 摘 要 】

Background

This study aimed to investigate risk factors for colonisation with extensively drug-resistant P. aeruginosa (XDR-PA) in immunocompromised patients and to build a clinical risk score (CRS) based on these results.

Methods

We conducted a matched case–control study with 31 cases and 93 controls (1:3). Cases were colonised with XDR-PA during hospitalisation. Independent risk factors were determined using a three step conditional logistic regression procedure. A CRS was built with respect to the corresponding risk fraction of each risk factor, and its discriminatory power was estimated by receiver operating characteristic (ROC) analysis.

Results

The presence of a central venous catheter (OR 7.41, P = 0.0008), the presence of a urinary catheter (OR 21.04, P < 0.0001), CRP > 10 mg/dl (OR 7.36, P = 0.0015), and ciprofloxacin administration (OR 5.53, P = 0.025) were independent risk factors. The CRS exhibited a high discriminatory power, defining a high risk population with an approximately fourteen times greater risk for XDR-PA colonisation.

Conclusions

Unnecessary use of antibiotics, particularly ciprofloxacin should be avoided, and a high standard of infection control measures must be achieved when using medical devices. A CRS can be used for adaptation of the active screening culture policy to the local setting.

【 授权许可】

   
2014 Willmann et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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