Differential effect of prior beta-lactams and fluoroquinolones on risk of bloodstream infections secondary to Pseudomonas aeruginosa

作者：Hammer Katie Lynn^*; Justo Julie Ann; Bookstaver P Brandon; Kohn Joseph; Albrecht Helmut; Al Hasan Majdi N

来源：Diagnostic Microbiology and Infectious Disease, 2017, 87(1): 87-91.

DOI：10.1016/j.diagmicrobio.2016.09.017

• Bacteremia
• Antimicrobial agents
• Sepsis
• Antibiotic resistance
• Pseudomonas aeruginosa

Objective: This retrospective case-control study examines risk factors for bloodstream infections (BSI) due to Pseudomonas aeruginosa (PSA).
Methods: Hospitalized adults with Gram-negative BSI at Palmetto Health from 2010 to 2015 were identified. Multivariate logistic regression was used to examine PSA BSI risk factors.
Results: Seventy and 910 patients with PSA and Enterobacteriaceae BSI, respectively, were included. Prior use of beta-lactams (adjusted odds ratio [aOR] 3.9, 95% confidence intervals [CI]: 23-6.9), but not fluoroquinolones (aOR 1.0, 95% CI: 0.4-2.2), was a risk factor for PSA BSI. Immune compromised status (aOR 3.7, 95% CI: 2.0-6.7), respiratory source (aOR 4.4, 95% CI: 2.1-8.9), and prolonged hospitalization (aOR 1.9, 95% CI: 1.1-3.5), were predictors of PSA BSI.
Conclusions: Determination of class of previously used antibiotics among other clinical variables helps identify patients at risk of PSA BSI and offers opportunities to optimize empirical antimicrobial therapy.

• 出版日期2017-1