title: Increasing frequency of Pseudomonas aeruginosa infections during tigecycline use.
abstract: BACKGROUND
  The widespread use of tigecycline raises the question of increasing infection rates of Pseudomonas aeruginosa (PA) in ICUs which are not affected by this antibiotic.
  
  
  OBJECTIVE
  The aim of this study was to determine if treatment with tigecycline is a risk factor for PA infection in ICU patients.
  
  
  METHODS
  A retrospective and observational study was conducted at Erciyes University Hospital, Turkey, between 2008 and 2010. The Erciyes University Hospital is a 1300-bed tertiary care facility. The patients included in this study were hospitalized in four adult ICUs. Patients with PA infections (case group) were compared with patients with nosocomial infection other than PA (control group).
  
  
  RESULTS
  A total of 1,167 patients with any nosocomial infections were included in the study. Two hundred and seventy eight (23.8%) of the patients had PA infection during their ICU stay. Fifty nine patients (21.2%) in the case group received tigecycline before developing PA infections, which were found to be significantly more frequent than in the controls (p < 0.01). Multivariate analysis showed that risk factors for PA infection were previous tigecycline use (4 times), external ventricular shunt (4.2 times), thoracic drainage catheter (2.5 times) and tracheostomy (1.6 times).
  
  
  CONCLUSIONS
  Our results contribute to the need for new studies to determine the safety of tigecycline use, especially for the treatment of critically ill patients. Since tigecycline seems to be an alternative for the treatment of multidrug resistant (MDR) microorganisms, rational use of this antibiotic in ICU patients is essential.
authors.affiliation: Faculty of Medicine, Erciyes University, Kayseri, Turkey. draysegululu@yahoo.co.uk.
authors.forename: Aysegul
authors.initials: A
authors.lastname: Ulu-Kilic
authors.forename: Emine
authors.initials: E
authors.lastname: Alp
authors.forename: Dilek
authors.initials: D
authors.lastname: Altun
authors.forename: Fatma
authors.initials: F
authors.lastname: Cevahir
authors.forename: Gamze
authors.initials: G
authors.lastname: Kalın
authors.forename: Hayati
authors.initials: H
authors.lastname: Demiraslan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011552:Pseudomonas Infections / Q000453:epidemiology*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D012189:Retrospective Studies; D018570:Risk Assessment; D062606:Tertiary Care Centers; D000078304:Tigecycline; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000078304:Tigecycline; D008911:Minocycline