title: Risk factors for infections with multidrug-resistant Pseudomonas aeruginosa in patients with cancer.
abstract: BACKGROUND
  Pseudomonas aeruginosa is responsible for a wide range of infections. In immunocompromised patients with cancer, the emergence of multidrug resistant P. aeruginosa may have grave consequences.
  
  
  METHODS
  Patients with cancer who were infected with multidrug-resistant P. aeruginosa with polyclonal DNA restriction patterns were used as the case group. Two control groups were used: one group of cancer patients who were infected with multidrug-susceptible P. aeruginosa and another group of cancer patients who had the same underlying disease and the same intensive care unit exposure as patients in the case group but who were not infected or colonized by P. aeruginosa.
  
  
  RESULTS
  Risk factors that were associated significantly with multidrug-resistant P. aeruginosa infection were the use of carbapenem for > or = 7 days, a history of P. aeruginosa infection during the preceding year, and a history of chronic obstructive pulmonary disease (P < 0.01).
  
  
  CONCLUSIONS
  Carbapenems may need to be used more judiciously as first-line empirical therapy for cancer patients with prior pseudomonal infection or chronic obstructive pulmonary disease who require hospitalization, and alternative, antipseudomonal antibiotic regimens may need to be considered, especially in this patient population.
authors.affiliation: Division of Infectious Diseases, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Ohmagari
authors.forename: Hend
authors.initials: H
authors.lastname: Hanna
authors.forename: Linda
authors.initials: L
authors.lastname: Graviss
authors.forename: Brenda
authors.initials: B
authors.lastname: Hackett
authors.forename: Cheryl
authors.initials: C
authors.lastname: Perego
authors.forename: Virginia
authors.initials: V
authors.lastname: Gonzalez
authors.forename: Tanya
authors.initials: T
authors.lastname: Dvorak
authors.forename: Holly
authors.initials: H
authors.lastname: Hogan
authors.forename: Ray
authors.initials: R
authors.lastname: Hachem
authors.forename: Kenneth
authors.initials: K
authors.lastname: Rolston
authors.forename: Issam
authors.initials: I
authors.lastname: Raad
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015780:Carbapenems / Q000627:therapeutic use; D016022:Case-Control Studies; D024881:Drug Resistance, Bacterial; D018432:Drug Resistance, Multiple; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D011552:Pseudomonas Infections / Q000209:etiology*; D011550:Pseudomonas aeruginosa; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems