title: Epidemiology of ciprofloxacin-resistant Pseudomonas aeruginosa in a veterans affairs hospital.
abstract: This study was performed to identify risk factors for the nosocomial acquisition of ciprofloxacin-resistant Pseudomonas aeruginosa (CRPA) in a Veterans Administration hospital between January 1994, and March 1995. The study was a retrospective comparison of host factors and in-hospital exposures of patients who acquired nosocomially CRPA and ciprofloxacin-sensitive P. aeruginosa (CSPA). Participants included 42 adult patients with nosocomial CRPA acquisition and 52 adult patients with nosocomial CSPA acquisition. Before pseudomonal acquisition, antecedent ciprofloxacin receipt (50% compared with 8%; odds ratio [OR], 12; p = 0.001), the presence of an indwelling airway (36% compared to 17%; OR, 2.6; p = 0.04), and documented antecedent infection (74% compared to 52%; OR, 2.6; p = 0.03) were significantly associated with acquisition of CRPA. On multivariate analysis, antecedent ciprofloxacin receipt (OR, 16.8; p = 0.0001) and presence of an indwelling airway (OR, 10.5; p = 0.009) remain as significant associations. Furthermore, the test of significance confirmed synergy between these two factors. Antecedent ciprofloxacin therapy and indwelling airway act independently and synergistically to promote CRPA acquisition.
authors.affiliation: Finch University of Health Sciences/The Chicago Medical School, and North Chicago VA Medical Center, North Chicago, IL 60064, USA.
authors.forename: W
authors.initials: W
authors.lastname: Khayr
authors.forename: W
authors.initials: W
authors.lastname: Rheault
authors.forename: L
authors.initials: L
authors.lastname: Waiters
authors.forename: A
authors.initials: A
authors.lastname: Walters
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D000890:Anti-Infective Agents / Q000494:pharmacology*; D016009:Chi-Square Distribution; D002939:Ciprofloxacin / Q000494:pharmacology*; D004352:Drug Resistance, Microbial; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000302:isolation & purification; D012189:Retrospective Studies
chemical_list: D000890:Anti-Infective Agents; D002939:Ciprofloxacin