Risk factors for hospital-acquired pneumonia caused by carbapenem-resistant Gram-negative bacteria in critically ill patients: a multicenter study in Korea

Diagn Microbiol Infect Dis. 2014 Apr;78(4):457-61. doi: 10.1016/j.diagmicrobio.2013.08.011. Epub 2014 Jan 23.

Abstract

We performed a case-control study to identify risk factors of carbapenem-resistant Gram-negative bacteria (CRGNB) as an increasing cause of hospital-acquired pneumonia (HAP). The study included critically ill adult patients with HAP whose microbial etiology was identified at eight tertiary centers in Korea between June 2008 and December 2009. Eighty two patients with 86 isolates of CRGNB (62 Acinetobacter baumannii, 14 Pseudomonas aeruginosa, and 10 Stenotrophomonas maltophilia) were included in the case group, and 122 patients with carbapenem-susceptible Gram-negative bacteria were included in the control group. Diabetes mellitus (adjusted odds ratio [aOR] 2.82, 95% confidence interval [95% CI] 1.25-6.38), radiologic score ≥5 (aOR 4.56, 95% CI 2.36-8.81), prior fluoroquinolone (aOR 2.39. 95% CI = 1.07-5.35), or carbapenem usage (aOR 2.82, 95% CI 1.75-17.83) were found to be independent risk factors. Fluoroquinolone and carbapenem should be cautiously used to avoid HAP caused by CRGNB.

Keywords: Carbapenem-resistant Gram-negative bacteria; Hospital-acquired pneumonia; Risk factor.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anti-Bacterial Agents / pharmacology*
  • Carbapenems / pharmacology*
  • Critical Illness
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • Female
  • Gram-Negative Bacteria / drug effects*
  • Gram-Negative Bacteria / isolation & purification
  • Gram-Negative Bacterial Infections / epidemiology*
  • Gram-Negative Bacterial Infections / microbiology
  • Humans
  • Male
  • Middle Aged
  • Pneumonia, Bacterial / epidemiology*
  • Pneumonia, Bacterial / microbiology
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Risk Factors
  • beta-Lactam Resistance*

Substances

  • Anti-Bacterial Agents
  • Carbapenems