Risk factors for nosocomial infections due to Pseudomonas aeruginosa producing metallo-β-lactamase in two tertiary-care teaching hospitals

• Published in: Journal of antimicrobial chemotherapy 2006-10, Vol.58 (4), p.882-885
• Main Authors: Zavascki, Alexandre Prehn, Barth, Afonso Luís, Gaspareto, Patrick Barcelos, Gonçalves, Ana Lúcia Saraiva, Moro, Ana Lúcia Didonet, Fernandes, Juliana Fernandez, Goldani, Luciano Zubaran
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anti-Bacterial Agents - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; bacterial drug resistance; beta-Lactamases - biosynthesis; beta-Lactams - therapeutic use; Biological and medical sciences; Case-Control Studies; Cross Infection - drug therapy; Cross Infection - epidemiology; Cross Infection - microbiology; Female; fluoroquinolones; Fluoroquinolones - therapeutic use; Hospitals, Teaching; Humans; Incidence; Male; Medical sciences; Middle Aged; multiple bacterial drug resistance; P. aeruginosa; Pharmacology. Drug treatments; Pseudomonas aeruginosa; Pseudomonas aeruginosa - drug effects; Pseudomonas aeruginosa - enzymology; Pseudomonas Infections - drug therapy; Pseudomonas Infections - epidemiology; Pseudomonas Infections - microbiology; Risk Factors; SPM-1 β-lactamase; β-lactamases
• ISSN: 0305-7453; 1460-2091
• DOI: 10.1093/jac/dkl327

Objectives: To assess risk factors for nosocomial infections due to Pseudomonas aeruginosa producing metallo-β-lactamase (MBL-PA) in two teaching hospitals where horizontal dissemination has been demonstrated. Methods: A case–control study was performed in both hospitals (assigned as hospital 1 and 2). Cases were patients with MBL-PA infections and controls were those with non-MBL-PA infections. Multivariate analysis was performed to identify independent risk factors. Results: A total of 86 cases and 212 controls were included in the study. A logistic regression model showed that exposure to β-lactams [odds ratio (OR) 3.21; 95% confidence interval (CI) 1.74–5.93] or fluoroquinolones (OR 3.50; 95% CI 1.46–8.37) was associated with MBL-PA infections. Other independent risk factors were neurological disease (OR 3.00; 95% CI 1.61–5.58), urinary tract infection (OR 2.48; 95% CI 1.21–5.09) and renal failure (OR 2.29; 95% CI 1.13–4.65). Admission to hospital 1 (OR 5.97; 95% CI 3.45–14.09) and intensive care unit stay (OR 2.07; 95% CI 1.46–3.96) were also associated with increased risk for MBL-PA infections. Conclusions: β-Lactam exposure is an important risk factor for MBL-PA infections even in a setting where patient-to-patient transmission plays a major role in the spread of the isolates. Other risk factors deserve further investigation, particularly exposure to fluoroquinolones.