title: The ability of virulence factor expression by Pseudomonas aeruginosa to predict clinical disease in hospitalized patients.
abstract: BACKGROUND
  Pseudomonas aeruginosa is an opportunistic pathogen that frequently causes hospital acquired colonization and infection. Accurate identification of host and bacterial factors associated with infection could aid treatment decisions for patients with P. aeruginosa cultured from clinical sites.
  
  
  METHODS
  We identified a prospective cohort of 248 hospitalized patients with positive P. aeruginosa cultures. Clinical data were analyzed to determine whether an individual met predefined criteria for infection versus colonization. P. aeruginosa isolates were tested for the expression of multiple phenotypes previously associated with virulence in animal models and humans. Logistic regression models were constructed to determine the degree of association between host and bacterial factors with P. aeruginosa infection of the bloodstream, lung, soft tissue and urinary tract.
  
  
  RESULTS
  One host factor (i.e. diabetes mellitus), and one bacterial factor, a Type 3 secretion system positive phenotype, were significantly associated with P. aeruginosa infection in our cohort. Subgroup analysis of patients with P. aeruginosa isolated from the urinary tract revealed that the presence of a urinary tract catheter or stent was an additional factor for P. aeruginosa infection.
  
  
  CONCLUSIONS
  Among hospitalized patients with culture-documented P. aeruginosa, infection is more likely to be present in those with diabetes mellitus and those harboring a Type 3 secretion positive bacterial strain.
authors.affiliation: L2 Diagnostics, New Haven, Connecticut, United States of America.
authors.forename: Michel
authors.initials: M
authors.lastname: Ledizet
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Murray
authors.forename: Sailaja
authors.initials: S
authors.lastname: Puttagunta
authors.forename: Martin D
authors.initials: MD
authors.lastname: Slade
authors.forename: Vincent J
authors.initials: VJ
authors.lastname: Quagliarello
authors.forename: Barbara I
authors.initials: BI
authors.lastname: Kazmierczak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015169:Colony Count, Microbial; D005260:Female; D006760:Hospitalization; D054884:Host-Pathogen Interactions; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011552:Pseudomonas Infections / Q000382:microbiology*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification / Q000472:pathogenicity*; D012307:Risk Factors; D037521:Virulence Factors / Q000378:metabolism*; D055815:Young Adult
chemical_list: D037521:Virulence Factors