Pseudomonas aeruginosa (PA) is a globally prevalent opportunistic pathogen capable of causing a broad spectrum of bacterial conditions. Its emerging multidrug-resistant (MDRPA) and carbapenem-resistant (CRPA) strains, recognized as significant public health threats, boost mortality rates, healthcare costs, and impose substantial clinical challenges. This article discusses a retrospective cohort study determining risk factors for these hard-to-treat pathogens.
This study, the first to scrutinize such risk factors in Central and East China, analyzed clinical and laboratory inpatient data from 2017-2021 at two tertiary care hospitals. They applied generalized linear mixed models to discover risk factors for MDRPA and CRPA bloodstream infections (BSIs). On the list of significantly associated factors were central venous catheter usage, invasive ventilation (including use duration), urinary catheterization, gastric tube insertion, and the use of certain antibiotics (such as vancomycin, imipenem, and tigecycline).
While a respiratory infection surfaced as an independent risk factor for MDRPA BSIs (adjusted odds ratio(aOR) 2.10, 95% confidence interval(CI) 1.00–4.42; P = 0.049), CRPA BSIs revealed independent risk factors to be the use of invasive ventilation (aOR 2.82, 95% CI 1.36–5.84; P = 0.005) and having a history of tigecycline use (aOR 3.34, 95% CI 1.16–9.58; P = 0.025). However, circulatory system diseases (aOR 0.41, 95% CI 0.22–0.77; P = 0.006) along with the quantity of piperacillin-tazobactam used (aOR 0.83, 95% CI 0.72–0.96; P = 0.013) were identified as independent protective factors. Accounting for these observations, it is necessary to implement more prudent clinical interventions and antimicrobial therapy for patients predisposed to these risk factors to prevent and control MDRPA and CRPA BSIs.
In conclusion, this comprehensive research delivers valuable insights into the risk factors tied to MDRPA and CRPA BSIs, casting light on the importance of incorporating them into infection prevention and control strategies, optimizing clinical intervention, and tailoring antimicrobial therapy based on individual risk factors to provide patients the highest chances of warding off these dangerous infections.