Skip Navigation


JAC Advance Access originally published online on August 8, 2006
Journal of Antimicrobial Chemotherapy 2006 58(4):882-885; doi:10.1093/jac/dkl327
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
58/4/882    most recent
dkl327v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Zavascki, A. P.
Right arrow Articles by Goldani, L. Z.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Zavascki, A. P.
Right arrow Articles by Goldani, L. Z.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2006. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

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

Alexandre Prehn Zavascki1,2,*, Afonso Luís Barth2,3, Patrick Barcelos Gaspareto3, Ana Lúcia Saraiva Gonçalves3, Ana Lúcia Didonet Moro4, Juliana Fernandez Fernandes5 and Luciano Zubaran Goldani2,6

1 Infectious Diseases Service, Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul Porto Alegre, Brazil 2 Medicine: Medical Sciences Postgraduate Program, Universidade Federal do Rio Grande do Sul, Porto Alegre Brazil 3 Microbiology Unit, Clinical Pathology Service, Hospital de Clínicas de Porto Alegre Porto Alegre, Brazil 4 Medical School, Pontifícia Universidade Católica do Rio Grande do Sul Porto Alegre, Brazil 5 Medical School, Universidade Federal do Rio Grande do Sul Porto Alegre, Brazil 6 Division of Infectious Diseases, Hospital de Clínicas de Porto Alegre Porto Alegre, Brazil

Received 13 May 2006; returned 12 June 2006; revised 6 July 2006; accepted 15 July 2006

*Correspondence address. Serviço de Infectologia, Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, 6690 Ipiranga Avenue, 90610-000, Porto Alegre, Brazil. Tel/Fax: +55-51-33621850; E-mail: apzavascki{at}terra.com.br

Objectives: To assess risk factors for nosocomial infections due to Pseudomonas aeruginosa producing metallo-ß-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 ß-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: ß-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.

Keywords: bacterial drug resistance , multiple bacterial drug resistance , fluoroquinolones , SPM-1 ß-lactamase , P. aeruginosa , ß-lactamases , case–control studies


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.