The risk factors for acquisition of imipenem-resistant Pseudomonas aeruginosa in the burn unit.
OBJECTIVE
This study was conducted to determine the risk factors for acquisition of imipenem-resistant Pseudomonas aeruginosa (IRPA) in the burn unit.


METHODS
Patients hospitalized in the burn unit from July 2003 to November 2004 were included in this study. The features of patients with isolated IRPA were compared with those of patients with isolated imipenem-susceptible P. aeruginosa (ISPA). Demographic features, total burn surface area (TBSA), burn depth, antimicrobials used in 15-day period before isolation, and presence of IRPA in the unit at the same period were included in the risk factors analysis.


RESULTS
P. aeruginosa was recovered from 133 patients in this period, 93 were IRPA and 40 were ISPA. There was no significant difference between patients with ISPA and patients with IRPA in terms of age, TBSA, and burn depth. In multivariate logistic regression analysis, hospital stay before isolation (odds ratio (OR): 3.6), carbapenem usage (OR: 7.4), broad-spectra antibiotic usage (OR: 6.5), previous presence of ISPA in the patient (OR: 1.7) and presence of IRPA in the unit at the same period (OR: 2.6) were independent risk factors for acquisition of IRPA.


CONCLUSIONS
Long hospitalization time, previous imipenem/meropenem use, previous broad-spectra antibiotic use, previous presence of ISPA in a patient and presence of IRPA in a unit at the same period were associated with acquisition of IRPA in the burn unit. In order to decrease the incidence of IRPA isolation, the usage of broad-spectra antibiotics, especially carbapenem, should be restricted, hospitalization time should be shortened if possible, and universal isolation precautions should be strictly applied to prevention cross-contamination.
Department of Clinical Bacteriology and Infectious Diseases, School of Medicine, Ataturk University, Erzurum, Turkey. zozkurt@atauni.edu.tr
Zulal
Z
Ozkurt
Mustafa
M
Ertek
Serpil
S
Erol
Ulku
U
Altoparlak
M Nuran
MN
Akcay
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002053:Burn Units; D002056:Burns / Q000382:microbiology*; D016022:Case-Control Studies; D003428:Cross Infection / Q000188:drug therapy*; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use*; D007902:Length of Stay; D008297:Male; D011552:Pseudomonas Infections / Q000188:drug therapy*; D011550:Pseudomonas aeruginosa / Q000187:drug effects*; D012189:Retrospective Studies; D012307:Risk Factors
D000900:Anti-Bacterial Agents; D015378:Imipenem