Differential effect of prior β-lactams and fluoroquinolones on risk of bloodstream infections secondary to Pseudomonas aeruginosa.
OBJECTIVE
This retrospective case-control study examines risk factors for bloodstream infections (BSI) due to Pseudomonas aeruginosa (PSA).


METHODS
Hospitalized adults with Gram-negative BSI at Palmetto Health from 2010 to 2015 were identified. Multivariate logistic regression was used to examine PSA BSI risk factors.


RESULTS
Seventy and 910 patients with PSA and Enterobacteriaceae BSI, respectively, were included. Prior use of β-lactams (adjusted odds ratio [aOR] 3.9, 95% confidence intervals [CI]: 2.3-6.9), but not fluoroquinolones (aOR 1.0, 95% CI: 0.4-2.2), was a risk factor for PSA BSI. Immune compromised status (aOR 3.7, 95% CI: 2.0-6.7), respiratory source (aOR 4.4, 95% CI: 2.1-8.9), and prolonged hospitalization (aOR 1.9, 95% CI: 1.1-3.5), were predictors of PSA BSI.


CONCLUSIONS
Determination of class of previously used antibiotics among other clinical variables helps identify patients at risk of PSA BSI and offers opportunities to optimize empirical antimicrobial therapy.
Department of Clinical Pharmacy, Carolinas HealthCare System, Charlotte, NC, USA. Electronic address: Katie.Hammer@carolinashealthcare.org.
Katie Lynn
KL
Hammer
Department of Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy, University of South Carolina, Columbia, SC, USA; Department of Pharmacy, Palmetto Health Richland, Columbia, SC, USA.
Julie Ann
JA
Justo
Department of Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy, University of South Carolina, Columbia, SC, USA; Department of Pharmacy, Palmetto Health Richland, Columbia, SC, USA.
P Brandon
PB
Bookstaver
Department of Pharmacy, Palmetto Health Richland, Columbia, SC, USA.
Joseph
J
Kohn
Department of Medicine, Division of Infectious Diseases, University of South Carolina School of Medicine, Columbia, SC, USA.
Helmut
H
Albrecht
Department of Medicine, Division of Infectious Diseases, University of South Carolina School of Medicine, Columbia, SC, USA.
Majdi N
MN
Al-Hasan
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000453:epidemiology*; D016022:Case-Control Studies; D004755:Enterobacteriaceae / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000453:epidemiology; D005260:Female; D024841:Fluoroquinolones / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000453:epidemiology*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D018570:Risk Assessment; D047090:beta-Lactams / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D047090:beta-Lactams
Antibiotic resistance; Antimicrobial agents; Bacteremia; Pseudomonas aeruginosa; Sepsis