Risk factors of oropharyngeal carriage of Pseudomonas aeruginosa among patients from a Medical-Surgical Intensive Care Unit.
Oropharyngeal carriage of Pseudomonas aeruginosa is associated with increased risk of infection and may provide a source for spread of drug-resistant strains. In order to assess the incidence and risk factors of oropharyngeal carriage, we conducted a retrospective cohort study based on results of surveillance cultures (oropharyngeal swabs) from a medical-surgical intensive care unit, collected from March 2005 through May 2006. Variables investigated included demographic characteristics, comorbid conditions, invasive procedures, use of devices and use of antimicrobials. Thirty case patients with P. aeruginosa carriage were identified. Other 84 patients with surveillance cultures negative to P. aeruginosa were enrolled as control subjects. Case patients were more likely to have a solid malignancy (Odds Ratio [OR] = 12.04, 95% Confidence Interval [CI] = 1.93-75.09, p=0.008), Acquired Immunodeficiency Syndrome (AIDS, OR = 7.09, 95% CI= 1.11-45.39, p = 0.04), central nervous system disease (OR = 4.51, 95% CI = 1.52-13.39, p = 0.007), or to have a central venous catheter placed (OR = 7.76, 95% CI = 1.68-35.79, p=0.009). The use of quinolones was a protective factor (OR = 0.13, 95% CI = 0.03-0.47, p = 0.002). The predominance of comorbidities as risk factors points out a group of patients to whom preventive measures should be directed.
Fortaleza
Carlos Magno Castelo Branco
CM
Department of Tropical Diseases, Botucatu School of Medicine, State University of São Paulo, Botucatu, SP. cmfortaleza@uol.com.br
Figueiredo
Lígia Castellon
LC
Beraldo
Carolina Contador
CC
Melo
Edson Carvalho de
EC
Póla
Patrícia Maria Sales
PM
Aragão
Valéria Drummond Nagem
VD
D000900:Anti-Bacterial Agents; D002353:Carrier State / Q000382:microbiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009960:Oropharynx / Q000382:microbiology*; D011552:Pseudomonas Infections / Q000382:microbiology*; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000302:isolation & purification*; D012189:Retrospective Studies; D012307:Risk Factors
D000900:Anti-Bacterial Agents