title: Multidrug-resistant Pseudomonas aeruginosa infections pose growing threat to health care-associated infection control in the hospitals of Southern China: a case-control surveillance study.
abstract: BACKGROUND
  Multidrug-resistant Pseudomonas aeruginosa (MDRPA) is one of the most common agents among health care-associated infections. There is a lack of data on the clinical features of MDRPA from Southern China.
  
  
  METHODS
  A case-control surveillance study of P aeruginosa was conducted based on surveillance from July 2008-December 2012, in 5 hospitals of Guangzhou, China. Data were analyzed by univariate analysis and multivariate logistic regression using Stata 13 (StataCorp, College Station, TX).
  
  
  RESULTS
  Of the 348 P aeruginosa strains, the prevalence of MDRPA was 54%, and it has increased over time. Isolates of P aeruginosa showed increased resistance to most antimicrobials during this time period. Independent risk factors were tracheal intubation insertion (odds ratio [OR], 2.21; 95% confidence interval [CI], 1.16-4.23; P = .02) and use of carbapenem (odds ratio [OR], 3.36; 95% confidence interval [CI], 1.75-6.47; P < .01). The distribution of MDRPA infections was uneven among the 5 hospitals (P = .01). Being infected with MDRPA strains resulted in longer duration of hospitalization (39 vs 24 days) and higher mortality (49% vs 20%).
  
  
  CONCLUSIONS
  The infections of MDRPA were severe issues. More stringent measures should be applied for those with independent predictors of MDRPA infections because they may induce adverse clinical outcomes.
authors.affiliation: Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China; Guangdong Key Laboratory of Molecular Epidemiology, Guangdong Pharmaceutical University, Guangzhou, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Peng
authors.affiliation: Department of Environmental and School Health, Shajing Health Inspection Institute, Shenzhen, China.
authors.forename: Jiaqi
authors.initials: J
authors.lastname: Bi
authors.affiliation: Department of Preventative Medicine, Hebei University of Chinese Medicine, Shijiazhuang, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Shi
authors.affiliation: Division of Environmental Health, Public Health Laboratory Center, Guangdong Pharmaceutical University, Guangzhou, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China; Guangdong Key Laboratory of Molecular Epidemiology, Guangdong Pharmaceutical University, Guangzhou, China.
authors.forename: Xiaohua
authors.initials: X
authors.lastname: Ye
authors.affiliation: Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China; Guangdong Key Laboratory of Molecular Epidemiology, Guangdong Pharmaceutical University, Guangzhou, China.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China; Guangdong Key Laboratory of Molecular Epidemiology, Guangdong Pharmaceutical University, Guangzhou, China. Electronic address: zhjyao2001@yahoo.com.
authors.forename: Zhenjiang
authors.initials: Z
authors.lastname: Yao
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015780:Carbapenems / Q000627:therapeutic use; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D003141:Communicable Diseases / Q000453:epidemiology* / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D062665:Epidemiological Monitoring; D005260:Female; D006760:Hospitalization; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000592:standards*; D007442:Intubation, Intratracheal / Q000009:adverse effects; D016015:Logistic Models; D015995:Prevalence; D011552:Pseudomonas Infections / Q000453:epidemiology* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems
keywords: Case-control surveillance; Multidrug-resistant Pseudomonas aeruginosa; Southern China