Risk factors for hospital-acquired pneumonia caused by carbapenem-resistant Gram-negative bacteria in critically ill patients: a multicenter study in Korea.
We performed a case-control study to identify risk factors of carbapenem-resistant Gram-negative bacteria (CRGNB) as an increasing cause of hospital-acquired pneumonia (HAP). The study included critically ill adult patients with HAP whose microbial etiology was identified at eight tertiary centers in Korea between June 2008 and December 2009. Eighty two patients with 86 isolates of CRGNB (62 Acinetobacter baumannii, 14 Pseudomonas aeruginosa, and 10 Stenotrophomonas maltophilia) were included in the case group, and 122 patients with carbapenem-susceptible Gram-negative bacteria were included in the control group. Diabetes mellitus (adjusted odds ratio [aOR] 2.82, 95% confidence interval [95% CI] 1.25-6.38), radiologic score ≥5 (aOR 4.56, 95% CI 2.36-8.81), prior fluoroquinolone (aOR 2.39. 95% CI = 1.07-5.35), or carbapenem usage (aOR 2.82, 95% CI 1.75-17.83) were found to be independent risk factors. Fluoroquinolone and carbapenem should be cautiously used to avoid HAP caused by CRGNB.
Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Tark
T
Kim
Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Center for Antimicrobial Resistance and Microbial Genetics, University of Ulsan, Seoul, Republic of Korea.
Yong Pil
YP
Chong
Division of Infectious Diseases, Department of Internal Medicine, Dongguk University Ilsan Hospital, Seoul, Republic of Korea.
Seong Yeon
SY
Park
Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea.
Min-Hyok
MH
Jeon
Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea.
Eun Joo
EJ
Choo
Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea.
Jin-Won
JW
Chung
Division of Respiratory Medicine, Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Republic of Korea.
Hyun Kyung
HK
Lee
Division of Infectious Diseases, Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Republic of Korea.
Chisook
C
Moon
Division of Infectious Diseases, Department of Internal Medicine, Chosun University Hospital, Gwangju, Republic of Korea.
Dong-Min
DM
Kim
Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Kyong Ran
KR
Peck
Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Center for Antimicrobial Resistance and Microbial Genetics, University of Ulsan, Seoul, Republic of Korea. Electronic address: yskim@amc.seoul.kr.
Yang Soo
YS
Kim
D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D015780:Carbapenems / Q000494:pharmacology*; D016638:Critical Illness; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000453:epidemiology* / Q000382:microbiology; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D018440:beta-Lactam Resistance
D000900:Anti-Bacterial Agents; D015780:Carbapenems
Carbapenem-resistant Gram-negative bacteria; Hospital-acquired pneumonia; Risk factor