Factors associated with epidemic multiresistant Pseudomonas aeruginosa infections in a hospital with AIDS-predominant admissions.
BACKGROUND
Infections caused by multiresistant Pseudomonas aeruginosa (MR-PA) have been associated with persistent infections and high mortality in acquired immunodeficiency syndrome (AIDS) patients. Therefore, understanding the predisposing factors for infection/colonization by this agent is critical for controlling outbreaks caused by MR-PA in settings with AIDS patients.


OBJECTIVE
To analyze the presence of factors associated with the acquisition of an epidemic MR-PA strain in a hospital with AIDS-predominant admission. A case-control study was carried out in which cases and controls were gathered from a prospective cohort of all hospitalized patients in an infectious disease hospital during a five-year study period.


RESULTS
Multivariate logistic regression analysis demonstrated that enteral nutrition OR = 14.9), parenteral nutrition (OR = 10.7), and use of ciprofloxacin (OR = 8.9) were associated with a significant and independent risk for MR-PA acquisition.


CONCLUSIONS
Although cross-colonization was likely responsible for the outbreaks, the use of ciprofloxacin was also an important factor associated with the acquisition of an epidemic MR-PA strain. More studies are necessary to determine whether different types of nutrition could lead to modification of gastrointestinal flora, thereby increasing the risk for infection/colonization by MR-PA in this population.
Nosocomial Infection Research Laboratory, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, RJ, Brazil. marisargomes@ioc.fiocruz.br
Marisa Zenaide Ribeiro
MZ
Gomes
Raquel Vasconcellos C de
RV
Oliveira
Carolina Romero
CR
Machado
Magda de Souza da
Mde S
Conceição
Cristina Vieira de
CV
Souza
Maria Cristina da Silva
MC
Lourenço
Marise Dutra
MD
Asensi
D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology* / Q000401:mortality; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D003428:Cross Infection; D024901:Drug Resistance, Multiple, Bacterial; D058872:Epidemics; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000382:microbiology* / Q000401:mortality; D011550:Pseudomonas aeruginosa