title: Clinical and treatment-related risk factors for nosocomial colonisation with extensively drug-resistant Pseudomonas aeruginosa in a haematological patient population: a matched case control study.
abstract: BACKGROUND
  This study aimed to investigate risk factors for colonisation with extensively drug-resistant P. aeruginosa (XDR-PA) in immunocompromised patients and to build a clinical risk score (CRS) based on these results.
  
  
  METHODS
  We conducted a matched case-control study with 31 cases and 93 controls (1:3). Cases were colonised with XDR-PA during hospitalisation. Independent risk factors were determined using a three step conditional logistic regression procedure. A CRS was built with respect to the corresponding risk fraction of each risk factor, and its discriminatory power was estimated by receiver operating characteristic (ROC) analysis.
  
  
  RESULTS
  The presence of a central venous catheter (OR 7.41, P = 0.0008), the presence of a urinary catheter (OR 21.04, P < 0.0001), CRP > 10 mg/dl (OR 7.36, P = 0.0015), and ciprofloxacin administration (OR 5.53, P = 0.025) were independent risk factors. The CRS exhibited a high discriminatory power, defining a high risk population with an approximately fourteen times greater risk for XDR-PA colonisation.
  
  
  CONCLUSIONS
  Unnecessary use of antibiotics, particularly ciprofloxacin should be avoided, and a high standard of infection control measures must be achieved when using medical devices. A CRS can be used for adaptation of the active screening culture policy to the local setting.
authors.affiliation: Institute of Medical Microbiology and Hygiene, University of Tübingen, Tübingen, Germany. matthias.willmann@med.uni-tuebingen.de.|German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany. matthias.willmann@med.uni-tuebingen.de.
authors.forename: Matthias
authors.initials: M
authors.lastname: Willmann
authors.affiliation: Institute of Medical Microbiology and Hygiene, University of Tübingen, Tübingen, Germany. anna@klimek.de.|German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany. anna@klimek.de.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Klimek
authors.affiliation: Medical Center, Department of Hematology, Oncology, Immunology, Rheumatology & Pulmonology, University of Tübingen, Tübingen, Germany. wichard.vogel@med.uni-tuebingen.de.
authors.forename: Wichard
authors.initials: W
authors.lastname: Vogel
authors.affiliation: Institute of Medical Microbiology and Hygiene, University of Tübingen, Tübingen, Germany. jan.liese@med.uni-tuebingen.de.|German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany. jan.liese@med.uni-tuebingen.de.
authors.forename: Jan
authors.initials: J
authors.lastname: Liese
authors.affiliation: Institute of Medical Microbiology and Hygiene, University of Tübingen, Tübingen, Germany. matthias.marschal@med.uni-tuebingen.de.|German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany. matthias.marschal@med.uni-tuebingen.de.
authors.forename: Matthias
authors.initials: M
authors.lastname: Marschal
authors.affiliation: Institute of Medical Microbiology and Hygiene, University of Tübingen, Tübingen, Germany. ingo.autenrieth@med.uni-tuebingen.de.|German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany. ingo.autenrieth@med.uni-tuebingen.de.
authors.forename: Ingo B
authors.initials: IB
authors.lastname: Autenrieth
authors.affiliation: Institute of Medical Microbiology and Hygiene, University of Tübingen, Tübingen, Germany. silke.peter@med.uni-tuebingen.de.|German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany. silke.peter@med.uni-tuebingen.de.
authors.forename: Silke
authors.initials: S
authors.lastname: Peter
authors.affiliation: Institute of Medical Microbiology and Hygiene, University of Tübingen, Tübingen, Germany. michael.buhl@med.uni-tuebingen.de.|German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany. michael.buhl@med.uni-tuebingen.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Buhl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003428:Cross Infection / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006402:Hematologic Diseases / Q000150:complications / Q000628:therapy; D006801:Humans; D016867:Immunocompromised Host; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D012307:Risk Factors