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- 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.
- Authors
Willmann, Matthias; Klimek, Anna M.; Vogel, Wichard; Liese, Jan; Marschal, Matthias; Autenrieth, Ingo B.; Peter, Silke; Buhl, Michael
- 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.
- Subjects
NOSOCOMIAL infections; PSEUDOMONAS aeruginosa; HOSPITAL care; URINARY catheters; LOGISTIC regression analysis; HOSPITAL admission &; discharge; IMMUNODEFICIENCY; PATIENTS
- Publication
BMC Infectious Diseases, 2014, Vol 14, Issue 1, p221
- ISSN
1471-2334
- Publication type
Article
- DOI
10.1186/s12879-014-0650-9