Risk factors for infections with multidrug-resistant Pseudomonas aeruginosa in patients with cancer.
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.
Ohmagari
Norio
N
Division of Infectious Diseases, Shizuoka Cancer Center, Shizuoka, Japan.
Hanna
Hend
H
Graviss
Linda
L
Hackett
Brenda
B
Perego
Cheryl
C
Gonzalez
Virginia
V
Dvorak
Tanya
T
Hogan
Holly
H
Hachem
Ray
R
Rolston
Kenneth
K
Raad
Issam
I
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
D000900:Anti-Bacterial Agents; D015780:Carbapenems