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Cited by 269Antibiotic Resistance in BacteriaBacterial biofilms and quorum sensingInfections and bacterial resistance

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Risk factors for hospitalized patients with resistant or multidrug-resistant Pseudomonas aeruginosa infections: a systematic review and meta-analysis

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Raman, Gowri, Avendano, Esther E., Chan, Jeffrey, Merchant, Sanjay, Puzniak, Laura·2018·Antimicrobial Resistance & Infection Control
DOI 10.1186/s13756-018-0370-9PMC PMC6032536
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Abstract

Background: Identifying risk factors predicting acquisition of resistant Pseudomonas aeruginosa will aid surveillance and diagnostic initiatives and can be crucial in early and appropriate antibiotic therapy. We conducted a systematic review examining risk factors of acquisition of resistant P. aeruginosa among hospitalized patients. Methods: MEDLINE®, EMBASE®, and Cochrane Central were searched between 2000 and 2016 for studies examining independent risk factors associated with acquisition of resistant P. aeruginosa , among hospitalized patients. Random effects model meta-analysis was conducted when at least three or more studies were sufficiently similar. Results: Of the 54 eligible articles, 28 publications (31studies) examined multi-drug resistant (MDR) or extensively drug resistant (XDR) P. aeruginosa and 26 publications (29 studies) examined resistant P. aeruginosa. The acquisition of MDR P. aeruginosa , as compared with non-MDR P. aeruginosa , was significantly associated with intensive care unit (ICU) admission (3 studies: summary adjusted odds ratio [OR] 2.2) or use of quinolones (4 studies: summary adjusted OR 3.59). Acquisition of MDR or XDR compared with susceptible P. aeruginosa was significantly associated with prior hospital stay (4 studies: summary adjusted OR 1.90), use of quinolones (3 studies: summary adjusted OR 4.34), or use of carbapenems (3 studies: summary adjusted OR 13.68). The acquisition of MDR P. aeruginosa compared with non- P. aeruginosa was significantly associated with prior use of cephalosporins (3 studies: summary adjusted OR 3.96), quinolones (4 studies: summary adjusted OR 2.96), carbapenems (6 studies: summary adjusted OR 2.61), and prior hospital stay (4 studies: summary adjusted OR 1.74). The acquisition of carbapenem-resistant P. aeruginosa compared with susceptible P. aeruginosa , was statistically significantly associated with prior use of piperacillin-tazobactam (3 studies: summary adjusted OR 2.64), vancomycin (3 studies: summary adjusted OR 1.76), and carbapenems (7 studies: summary adjusted OR 4.36). Conclusions: Prior use of antibiotics and prior hospital or ICU stay was the most significant risk factors for acquisition of resistant P. aeruginosa . These findings provide guidance in identifying patients that may be at an elevated risk for a resistant infection and emphasize the importance of antimicrobial stewardship and infection control in hospitals.

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  • Risk factors often associated with P. aeruginosa infections include prior hospitalization, ICU stay, and previous use of antibiotics.

    “The risk factors often associated with P. aeruginosa infections include prior hospitalization, ICU stay, and previous use of antibiotics.174”

    From Antimicrobial Resistance Rates and Surveillance in Sub-Saharan Africa: Where Are We Now? (2022) · cites this paper as [174]

    The Discussion identifies prior hospital admission, ICU stay, and prior antibiotic use as risk factors for acquiring multidrug-resistant or extensively drug-resistant P. aeruginosa in hospitalized patients. The citing sentence omits that resistance qualification and presents them as risk factors for P. aeruginosa infections generally. (LLM, conf=0.88)

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Metadata

Authors
Raman, G., Avendano, E. E., Chan, J., Merchant, S., & Puzniak, L.
Affiliations
  • Tufts Medical Center (US)
  • Merck & Co., Inc., Rahway, NJ, USA (United States) (US)
Corresponding author
Raman, Gowri
ORCID
Venue
Antimicrobial Resistance & Infection Control
Publisher
Springer Science and Business Media LLC
Published
2018-07-04
Volume
7
Issue
1
Pages
79-79
ISSN
2047-2994 (ISSN-L)
DOI
10.1186/s13756-018-0370-9
PMC
PMC6032536
OpenAlex
W2810044729
Cited by
269
References
1
Citations by year
2026: 22 · 2025: 36 · 2024: 38 · 2023: 51 · 2022: 49 · 2021: 30 · 2020: 27 · 2019: 16
FWCI
1.52
Type
journal article
Language
en
Open access
Licence
Locations
  • Antimicrobial Resistance and Infection Control (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Merck & Co., Inc.
Topics
  • Health Sciences › Medicine › Microbiology (medical) › Antibiotic Resistance in Bacteria
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bacterial biofilms and quorum sensing
  • Health Sciences › Medicine › Microbiology (medical) › Infections and bacterial resistance
Keywords
Pseudomonas aeruginosa, multidrug resistance, extensively drug-resistant Pseudomonas aeruginosa, carbapenem resistance, risk factors, hospitalized patients, intensive care unit admission, antibiotic exposure, quinolones, carbapenems, piperacillin-tazobactam, vancomycin, antimicrobial resistance surveillance, infection acquisition
MeSH terms
Carbapenem-Resistant Enterobacteriaceae, Piperacillin, Tazobactam Drug Combination, Adult, Aged, Anti-Bacterial Agents, Cephalosporins, Critical Care, Cross Infection, Female, Humans, Intensive Care Units, Male, Middle Aged, Pseudomonas aeruginosa, Pseudomonas Infections, Risk Factors, Vancomycin, Quinolones, Carbapenems, Drug Resistance, Multiple, Bacterial

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