Pseudomonas aeruginosa nosocomial pneumonia: Impact of pneumonia classification

Scott T. Micek, Marin H. Kollef, Antoni Torres, Catherine Chen, Jordi Rello, Jean Chastre, Massimo Antonelli, Tobias Welte, Bernard Clair, Helmut Ostermann, Esther Calbo, Richard Wunderink, Francesco Menichetti, Garrett Schramm, Vandana Menon

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

objective. To describe and compare the mortality associated with nosocomial pneumonia due to Pseudomonas aeruginosa (Pa-NP) according to pneumonia classification (community-onset pneumonia [COP], hospital-acquired pneumonia [(HAP], and ventilator-associated pneumonia [VAP]). design. We conducted a retrospective cohort study of adults with Pa-NP. We compared mortality for Pa-NP among patients with COP, HAP, and VAP and used logistic regression to identify risk factors for hospital mortality and inappropriate initial antibiotic therapy (IIAT). setting. Twelve acute care hospitals in 5 countries (United States, 3; France, 2; Germany, 2; Italy, 2; and Spain, 3). patients/participants. A total of 742 patients with Pa-NP. results. Hospital mortality was greater for those with VAP (41.9%) and HAP (40.1%) compared with COP (24.5%) (P<.001). In multivariate analyses, independent predictors of hospital mortality differed by pneumonia classification (COP: need for mechanical ventilation and intensive care; HAP: multidrug-resistant isolate; VAP: IIAT, increasing age, increasing Charlson comorbidity score, bacteremia, and use of vasopressors). Presence of multidrug resistance was identified as an independent predictor of IIAT for patients with COP and HAP, whereas recent antibiotic administration was protective in patients with VAP. conclusions. Among patients with Pa-NP, pneumonia classification identified patients with different risks for hospital mortality. Specific risk factors for hospital mortality also differed by pneumonia classification and multidrug resistance appeared to be an important risk factor for IIAT. These findings suggest that pneumonia classification for P. aeruginosa identifies patients with different mortality risks and specific risk factors for outcome and IIAT.

Original languageEnglish (US)
Pages (from-to)1190-1197
Number of pages8
JournalInfection Control and Hospital Epidemiology
Volume36
Issue number10
DOIs
StatePublished - 2015

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

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    Micek, S. T., Kollef, M. H., Torres, A., Chen, C., Rello, J., Chastre, J., Antonelli, M., Welte, T., Clair, B., Ostermann, H., Calbo, E., Wunderink, R., Menichetti, F., Schramm, G., & Menon, V. (2015). Pseudomonas aeruginosa nosocomial pneumonia: Impact of pneumonia classification. Infection Control and Hospital Epidemiology, 36(10), 1190-1197. https://doi.org/10.1017/ice.2015.167