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Vol. 16. Issue 3.
La Mucoviscidose
Pages 219-225 (May - June 2012)
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Vol. 16. Issue 3.
La Mucoviscidose
Pages 219-225 (May - June 2012)
Open Access
Factors associated with epidemic multiresistant Pseudomonas aeruginosa infections in a hospital with AIDS-predominant admissions
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Marisa Zenaide Ribeiro Gomesa,b,
Corresponding author
marisargomes@ioc.fiocruz.br

Corresponding author at: Laboratório de Pesquisa em Infecção Hospitalar, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Avenida Brasil, 4365, Pavilhão Rocha Lima - S319, Manguinhos, Rio de Janeiro, RJ, 21040–900, Brazil.
, Raquel Vasconcellos C. de Oliveirac, Carolina Romero Machadoc, Magda de Souza da Conceiçãoc, Cristina Vieira de Souzac, Maria Cristina da Silva Lourençoc, Marise Dutra Asensia
a Nosocomial Infection Research Laboratory, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (IOC/FIOCRUZ), RJ, Brazil
b Department of Infectious Diseases, Infection Control and Employee Health, University of Texas, MD Anderson Cancer Center, Texas, USA
c Infection Control Committee, Instituto de Pesquisa Clínica Evandro Chagas/FIOCRUZ, RJ, Brazil
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Abstract
Introduction

Infections caused by multiresistant Pseudomonas aeruginosa (MR-PA) have been associated with persistent infections and high mortality in acquired immunodeficiency syndrome (AIDS) patients. Therefore, understanding the predisposing factors for infection/colonization by this agent is critical for controlling outbreaks caused by MR-PA in settings with AIDS patients.

Objective and methods

To analyze the presence of factors associated with the acquisition of an epidemic MR-PA strain in a hospital with AIDS-predominant admission. A casecontrol study was carried out in which cases and controls were gathered from a prospective cohort of all hospitalized patients in an infectious disease hospital during a five-year study period.

Results

Multivariate logistic regression analysis demonstrated that enteral nutrition (OR=14.9), parenteral nutrition (OR=10.7), and use of ciprofloxacin (OR=8.9) were associated with a significant and independent risk for MR-PA acquisition.

Conclusions

Although cross-colonization was likely responsible for the outbreaks, the use of ciprofloxacin was also an important factor associated with the acquisition of an epidemic MR-PA strain. More studies are necessary to determine whether different types of nutrition could lead to modification of gastrointestinal flora, thereby increasing the risk for infection/colonization by MR-PA in this population.

Keywords:
Pseudomonas aeruginosa
Risk factors
Disease outbreaks
Molecular epidemiology
Acquired immunodeficiency syndrome
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The Brazilian Journal of Infectious Diseases
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