Risk factors for nosocomial infections due to Pseudomonas aeruginosa producing metallo-beta-lactamase in two tertiary-care teaching hospitals. Zavascki; Prehn, A.; Barth; Luís, A.; Gaspareto; Barcelos, P.; Gonçalves; Saraiva, A. L.; Moro; Didonet, A. L.; Fernandes; Fernandez, J.; Goldani; and Zubaran, L. The Journal of Antimicrobial Chemotherapy, 58(4):882--5, October, 2006. PMID: 16895936
Risk factors for nosocomial infections due to Pseudomonas aeruginosa producing metallo-beta-lactamase in two tertiary-care teaching hospitals [link]Paper  doi  abstract   bibtex   
OBJECTIVES: To assess risk factors for nosocomial infections due to Pseudomonas aeruginosa producing metallo-beta-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 beta-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: beta-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.
@article{ zavascki_risk_2006,
  abstract = {{OBJECTIVES:} To assess risk factors for nosocomial infections due to Pseudomonas aeruginosa producing metallo-beta-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 beta-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:} {beta-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.},
  added-at = {2011-03-11T10:05:34.000+0100},
  author = {Zavascki, Alexandre Prehn and Barth, Afonso Luís and Gaspareto, Patrick Barcelos and Gonçalves, Ana Lúcia Saraiva and Moro, Ana Lúcia Didonet and Fernandes, Juliana Fernandez and Goldani, Luciano Zubaran},
  biburl = {http://www.bibsonomy.org/bibtex/229811950b972d115db2472556dc63e19/jelias},
  doi = {10.1093/jac/dkl327},
  interhash = {d0c880050355b1532c460930b2f9f056},
  intrahash = {29811950b972d115db2472556dc63e19},
  issn = {0305-7453},
  journal = {The Journal of Antimicrobial Chemotherapy},
  keywords = {Adult, Aged, Agents, Cross Factors Female, Fluoroquinolones, Hospitals, Humans, Incidence, Infection, Infections, Male, Middle Pseudomonas Risk Studies, Teaching, aeruginosa, {Anti-Bacterial} {Case-Control} {beta-Lactamases,} {beta-Lactams,}},
  month = {October},
  note = {{PMID:} 16895936},
  number = {4},
  pages = {882--5},
  title = {Risk factors for nosocomial infections due to Pseudomonas aeruginosa producing metallo-beta-lactamase in two tertiary-care teaching hospitals},
  url = {http://www.ncbi.nlm.nih.gov/pubmed/16895936},
  volume = {58},
  year = {2006}
}
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