Risk Factors and Outcomes of Patients with Carbapenem-Resistant Pseudomonas aeruginosa Bloodstream Infection

Abstract

Purpose

The rising incidence of carbapenem-resistant Pseudomonas aeruginosa (PA) bloodstream infection (BSI) has made the selection of antibiotic therapy more difficult and caused high mortality. This study was aimed at exploring the risk factors for carbapenem-resistant Pseudomonas aeruginosa (CRPA) bloodstream infection and identifying the risk factors for the outcomes of patients with PA-BSI.

Methods

We performed a retrospective cohort study of patients with PA-BSI in a tertiary hospital from January 2017 to December 2021 in China. Epidemiological, clinical, and microbiological characteristics were described. Risk factors for CRPA-BSI and the outcomes of PA-BSI inpatients were identified, using multivariate logistic regression analysis.

Results

A total of 198 PA-BSI inpatients were included. The negative outcome rate was significantly higher in patients infected with CRPA (15/34, 44.12%) than with carbapenem-susceptible Pseudomonas aeruginosa (CSPA) (35/164, 21.34%), and the difference was statistically significant (P=0.005). Multivariate logistic regression analysis showed that previous exposure to carbapenem (OR 3.519, 95% CI 1.359–9.110, P=0.010) was an independent risk factor for CRPA-BSI. In addition, CRPA (OR 1.615, 95% CI 0.626–4.171, P=0.32) was not an independent risk factor for negative outcome among PA-BSI inpatients.

Conclusion

Our study showed that previous exposure to carbapenem was an independent risk factor for CRPA-BSI. CRPA was not an independent risk factor for a negative outcome in PA-BSI inpatients.

Keywords:

• carbapenem-resistant
• Pseudomonas aeruginosa bloodstream infection
• risk factors
• outcomes

Data Sharing Statement

Any datasets analyzed during this study are available from the corresponding author at reasonable request.

Ethical Approval

This study was approved by the Ethics Committee of the First Affiliated Hospital of Guangxi Medical University. The need for written informed consent was waived due to the retrospective non-interventional study and the research did not involve personal privacy or commercial interests. We declare that this study was conducted in accordance with the principles of the Declaration of Helsinki and the information of all patients included in this study was confidential.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no conflicts of interest in this work.

Additional information

Funding

This study was supported by the National Natural Science Foundation of China (81460431), the Natural Science Foundation of Guangxi (2018GXNSFAA 281123) and the scientific research project of Guangxi Health Commission (No. Z20201166).