Risk factors for hospital-acquired bacteremia due to carbapenem-resistant Pseudomonas aeruginosa in a Colombian hospital.
BACKGROUND
Bacteremia due to Pseudomonas aeruginosa resistant to carbapenems is a public health problem due to the limitations it places on therapeutic options, as well as the increased time patients must spend in hospital, costs and the risk of mortality.


OBJECTIVE
To evaluate the risk factors for presentation of bacteremia due to carbapenem-resistant P. aeruginosa acquired in the Hospital Universitario San Ignacio between January 2008 and June 2014.


METHODS
This was a case control study in which the case patients presented bacteremia due to P. aeruginosa resistant to carbapenems and the control group included patients with P. aeruginosa susceptible to this group of antibiotics. Variables such as the previous use of meropenem and ertapenem, immunosuppression and neoplasia were measured. Mortality and duration of hospital were also described.


RESULTS
In all, 168 patients were evaluated, of which 42 were cases and 126 controls. Using a multivariate model, the risk factors related to bacteremia due to carbapenem-resistant P. aeruginosa acquired in hospital were the following: use of parenteral nutrition (OR=8.28; 95% CI: 2.56-26.79; p=0); use of meropenem (OR=1.15; 95% CI: 1.03-1.28; p=0.01); and use of ciprofloxacin (OR=81.99; 95% CI: 1.14-5884; p=0.043).


CONCLUSIONS
In order to prevent the emergence of carbapenem-resistant P. aeruginosa, antimicrobial control programs should be strengthened by promoting the prudent administration of carbapenems and quinolones. The correct use of parenteral nutrition should also be monitored.
Grupo de Investigación en Enfermedades Infecciosas, Unidad de Infectología, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, D.C., Colombia. sandra.valderrama@gmail.com.
Sandra Liliana
SL
Valderrama
Pedro Felipe
PF
González
María Alejandra
MA
Caro
Natalia
N
Ardila
Beatriz
B
Ariza
Fabián
F
Gil
Carlos
C
Álvarez
D016470:Bacteremia / Q000188:drug therapy* / Q000382:microbiology; D015780:Carbapenems / Q000494:pharmacology*; D016022:Case-Control Studies; D002939:Ciprofloxacin / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D000077727:Ertapenem; D006761:Hospitals; D006801:Humans; D000077731:Meropenem; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects*; D012307:Risk Factors; D013845:Thienamycins / Q000494:pharmacology*; D047090:beta-Lactams / Q000494:pharmacology*
D015780:Carbapenems; D013845:Thienamycins; D047090:beta-Lactams; D002939:Ciprofloxacin; D000077731:Meropenem; D000077727:Ertapenem
Pseudomonas aeruginosa; bacteremia; ciprofloxacin; parenteral nutrition; risk factors