title: Nosocomial pulmonary infection by antimicrobial-resistant bacteria of patients hospitalized in intensive care units: risk factors and survival.
abstract: The objectives of this study were to identify the risk factors of nosocomial pulmonary infection (NPI) in intensive care units (ICUs) associated with antimicrobial-resistant bacteria (NPI-ARB) and to compare survival after NPI-ARB with NPI due to antimicrobial-sensitive bacteria (NPI-ASB). We analysed data from a surveillance network monitoring nosocomial infections in 27 mixed ICUs in the south-east of France. NPI surveillance data were recorded for 628 patients with documented NPI. The patients were stratified into 2 groups by type of pneumonia: NPI-ASB (445 patients) vs. NPI-ARB (183 patients). Variables associated with NPI-ARB were identified++ by multivariate logistic regression. Survival was calculated using the Kaplan-Meier method. A medical condition for ICU admission [odds ratio (OR) 1.98, 95% confidence interval (95% CI) 1.35-2.91], transfer from another hospital ward [OR 1.66, 95% CI (1.14-2.42)], a colonized central venous catheter [OR 3.47, 95% CI (1.46-8.21)], a stay of [eight days [OR 1.02, 95% CI (1.01-1. 05)] and mechanical ventilation [OR 2.10, 95% CI (1.31-3.36)] were independent risk factors of NPI-ARB. Median survival was 35 days after NPI-ARB and 32 days after NPI-ASB (P=0.92). Survival after bacterial NPI was not associated with antimicrobial susceptibility.
authors.affiliation: C. Clin Sud-Est, Centre Hospitalier Lyon-Sud, Lyon. philipva@lyon-sud.univ-lyonl.fr
authors.forename: P
authors.initials: P
authors.lastname: Vanhems
authors.forename: A
authors.initials: A
authors.lastname: Lepape
authors.forename: A
authors.initials: A
authors.lastname: Savey
authors.forename: P
authors.initials: P
authors.lastname: Jambou
authors.forename: J
authors.initials: J
authors.lastname: Fabry
mesh_terms: D000328:Adult; D003428:Cross Infection / Q000382:microbiology / Q000401:mortality / Q000517:prevention & control*; D004352:Drug Resistance, Microbial; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018410:Pneumonia, Bacterial / Q000382:microbiology / Q000401:mortality / Q000517:prevention & control*; D012307:Risk Factors; D016019:Survival Analysis