Risk factors for piperacillin-tazobactam-resistant Pseudomonas aeruginosa among hospitalized patients

Anthony D Harris; Eli Perencevich; Mary-Claire Roghmann; Glenn Morris; Keith S Kaye; Judith A Johnson

doi:10.1128/AAC.46.3.854-858.2002

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Risk factors for piperacillin-tazobactam-resistant Pseudomonas aeruginosa among hospitalized patients

Journal article

Open access

Peer reviewed

Risk factors for piperacillin-tazobactam-resistant Pseudomonas aeruginosa among hospitalized patients

Anthony D Harris, Eli Perencevich, Mary-Claire Roghmann, Glenn Morris, Keith S Kaye and Judith A Johnson

Antimicrobial agents and chemotherapy, Vol.46(3), pp.854-858

03/2002

DOI: 10.1128/AAC.46.3.854-858.2002

PMCID: PMC127481

PMID: 11850272

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Abstract

Antimicrobial resistance is an emerging problem with Pseudomonas aeruginosa. This study determined risk factors for the recovery of piperacillin-tazobactam-resistant P. aeruginosa from clinical cultures from hospitalized patients. A case-control study design was used to compare two groups of case patients with control patients. The first group of case patients was defined by nosocomial isolation of piperacillin-tazobactam-resistant P. aeruginosa, and the second group of cases yielded piperacillin-tazobactam-susceptible P. aeruginosa. Controls were selected in a 6:1 ratio from the same medical or surgical services among which piperacillin-tazobactam-resistant P. aeruginosa arose in patients. Risk factors analyzed included antimicrobial drug exposure, comorbid conditions, and demographics. Bivariate and multivariable analyses were performed. Piperacillin-tazobactam-resistant P. aeruginosa was isolated from 179 patients, and piperacillin-tazobactam-susceptible P. aeruginosa was isolated from 624 patients over a 2.5-year period. Piperacillin-tazobactam (odds ratio [OR] = 6.82; 95% confidence interval [CI], 4.56 to 10.21), imipenem (OR = 2.42; 95% CI, 1.19 to 4.94), aminoglycosides (OR = 2.18; 95% CI, 1.44 to 3.28), vancomycin (OR = 1.87; 95% CI, 1.21 to 2.89), and broad-spectrum cephalosporins (OR = 2.38; 95% CI, 1.45 to 3.88) were the antibiotics associated with the isolation of piperacillin-tazobactam-resistant P. aeruginosa. Exposure to vancomycin (OR = 1.53; 95% CI, 1.13 to 2.06) or ampicillin-sulbactam (OR = 2.28; 95% CI, 1.62 to 3.21) was associated with recovery of piperacillin-tazobactam-susceptible P. aeruginosa. In this study, antibiotics associated with piperacillin-tazobactam-susceptible P. aeruginosa were different from antibiotics associated with piperacillin-tazobactam-resistant P. aeruginosa. Piperacillin-tazobactam was a strong risk factor for piperacillin-tazobactam-resistant P. aeruginosa. Our results suggest that the nosocomial isolation of piperacillin-tazobactam-resistant P. aeruginosa may be affected by multiple antibiotics.

Humans

Middle Aged

Male

Penicillins - administration & dosage

Case-Control Studies

Piperacillin - administration & dosage

Penicillin Resistance

Penicillanic Acid - therapeutic use

Adult

Female

Penicillanic Acid - analogs & derivatives

Cross Infection - epidemiology

Penicillanic Acid - administration & dosage

Penicillins - therapeutic use

Pseudomonas Infections - drug therapy

Risk Factors

Drug Therapy, Combination - therapeutic use

Pseudomonas Infections - microbiology

Cross Infection - drug therapy

Drug Resistance, Microbial

Regression Analysis

Drug Therapy, Combination - administration & dosage

Pseudomonas Infections - epidemiology

Tazobactam

Cross Infection - microbiology

Piperacillin - therapeutic use

Details

Title: Subtitle: Risk factors for piperacillin-tazobactam-resistant Pseudomonas aeruginosa among hospitalized patients
Creators: Anthony D Harris - Department of Epidemiology and Preventive Medicine, University of Maryland-VA Maryland Health Care System, Baltimore, Maryland 21201, USA. aharris@epi.umaryland.edu
Eli Perencevich
Mary-Claire Roghmann
Glenn Morris
Keith S Kaye
Judith A Johnson
Resource Type: Journal article
Publication Details: Antimicrobial agents and chemotherapy, Vol.46(3), pp.854-858
Publisher: United States
DOI: 10.1128/AAC.46.3.854-858.2002
PMID: 11850272
PMCID: PMC127481
ISSN: 0066-4804
eISSN: 1098-6596
Grant note: K23 AI001752 / NIAID NIH HHS K23AI01752-01A1 / NIAID NIH HHS
Language: English
Date published: 03/2002
Academic Unit: Epidemiology; Internal Medicine
Record Identifier: 9983779289602771

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