Table 2 Relationship between Pseudomonas aeruginosa acquisition, characteristics on admission and exposures in the ICUa
Characteristics | Acquisition of P. aeruginosa | No acquisition of P. aeruginosa | OR | P -value |
|---|---|---|---|---|
(n =104) | (n =678) | (95% CI) | ||
Male sex | 36 (34.6) | 270 (39.8) | 0.8 (0.5 to 1.2) | 0.3 |
Pre-ICU hospital stay >3 days | 36 (34.6) | 143 (21.1) | 1.98 (1.3 to 3.1) | 0.002 |
Underlying diseases | ||||
Neutropenia | 4 (3.8) | 15 (2.2) | 1.77 (0.6 to 5.4) | 0.3 |
Haematological malignancy | 10 (9.6) | 93 (13.7) | 0.67 (0.3 to 1.3) | 0.2 |
Liver cirrhosis | 8 (7.7) | 22 (3.2) | 2.48 (1.1 to 5.7) | 0.03 |
Other conditions on admission | ||||
Prior antibiotic (≤1 mo) | 38 (36.5) | 194 (28.6) | 1.44 (0.9 to 2.2) | 0.1 |
Shock | 29 (27.9) | 105 (15.5) | 2.11 (1.3 to 3.4) | 0.002 |
Reason for admission | ||||
Infection | 67 (64.4) | 369 (54.4) | 1.52 (1 to 2.3) | 0.1 |
Postsurgical | 1 (1) | 78 (11.5) | 0.07 (0 to 0.5) | 0.001 |
Severity scores | ||||
APACHE II score ≥20 | 63 (60.6) | 328 (48.4) | 1.64 (1.1 to 2.5) | 0.02 |
SOFA score ≥7 | 64 (61.5) | 306 (45.1) | 1.95 (1.3 to 3) | 0.002 |
Non-antibiotic exposures | ||||
Days at risk, median (IQR) | 6 (4 to 11) | 5 (3 to 8) | – | 0.01 |
Colonization pressureb >0.43 | 5 (4.8) | 12 (1.8) | 2.8 (1 to 8.1) | 0.05 |
Mixing periods | 49 (47.1) | 281 (41.5) | 0.8 (0.5 to 1.2) | 0.2 |
CVC >3 days | 80 (76.9) | 472 (69.6) | 1.45 (0.9 to 2.4) | 0.1 |
Bladder catheterization | ||||
No | 2 (1.9) | 45 (6.6) | 1 | |
1 to 3 days | 23 (22.1) | 167 (24.6) | 3.1 (0.7 to 13.6) | 0.1 |
>3 days | 79 (76) | 466 (68.7) | 3.8 (0.9 to 16) | 0.1 |
Intubation | ||||
No | 15 (14.4) | 306 (45.1) | 1 | |
1 to 3 days | 23 (22.1) | 187 (27.6) | 2.5 (1.3 to 4.9) | 0.01 |
>3 days | 66 (63.5) | 185 (27.3) | 7.3 (4 to 13.1) | <0.001 |
Enteral nutrition | ||||
No | 47 (45.2) | 18 (76.4) | 1 | |
1 to 3 days | 21 (20.2) | 40 (5.9) | 5.8 (3.2 to 10.6) | <0.001 |
>3 days | 36 (34.6) | 120 (17.7) | 3.3 (2.1 to 5.3) | <0.001 |
Parenteral nutrition | ||||
No | 65 (62.5) | 566 (83.5) | 1 | |
1 to 3 days | 10 (9.6) | 21 (3.1) | 4.1 (1.9 to 9.2) | <0.001 |
>3 days | 29 (27.9) | 91 (13.4) | 2.8 (1.7 to 4.5) | <0.001 |
Tracheostomy | 48 (46.2) | 84 (12.4) | 6.06 (3.9 to 9.5) | <0.001 |
Endoscopy | 21 (20.2) | 77 (11.4) | 1.97 (1.2 to 3.4) | 0.01 |
Surgery | 18 (17.3) | 68 (10) | 1.88 (1.1 to 3.3) | 0.03 |
Blood transfusion | 45 (43.3) | 198 (29.2) | 1.85 (1.2 to 2.8) | 0.004 |
Antibiotic exposures during the ICU stay | ||||
Fluoroquinolone | ||||
No | 74 (71.2) | 447 (65.9) | 1 | |
1 to 3 days | 9 (8.7) | 85 (12.5) | 0.6 (0.3 to 1.3) | 0.2 |
>3 days | 21 (20.2) | 146 (21.5) | 0.9 (0.5 to 1.5) | 0.6 |
Carbapenem | ||||
No | 64 (61.5) | 483 (71.2) | 1 | |
1 to 3 days | 10 (9.6) | 64 (9.4) | 1.2 (0.6 to 2.4) | 0.7 |
>3 days | 30 (28.8) | 131 (19.3) | 1.7 (1.1 to 2.8) | 0.02 |
Ceftazidime | ||||
No | 94 (90.4) | 618 (91.2) | 1 | |
1 to 3 days | 0 (0) | 23 (3.4) | – | 1 |
>3 days | 10 (9.6) | 37 (5.5) | 1.8 (0.9 to 3.7) | 0.1 |
Piperacillin-tazobactam | ||||
No | 79 (76) | 549 (81) | 1 | |
1 to 3 days | 8 (7.7) | 45 (6.6) | 1.2 (0.6 to 2.7) | 0.6 |
>3 days | 17 (16.3) | 84 (12.4) | 1.4 (0.8 to 2.5) | 0.2 |
Amikacin | ||||
No | 99 (95.2) | 655 (96.6) | 1 | |
1 to 3 days | 1 (1) | 13 (1.9) | 0.5 (0.1 to 3.9) | 0.5 |
>3 days | 4 (3.8) | 10 (1.5) | 2.6 (0.8 to 8.6) | 0.1 |
Any antibiotic | 102 (98.1) | 578 (85.3) | 8.82 (2.1 to 36.3) | <0.001 |
Any antipseudomonal antibiotic | ||||
No | 30 (28.8) | 246 (36.3) | 1 | |
1 to 3 days | 22 (21.2) | 188 (27.7) | 1 (0.5 to 1.7) | 0.9 |
>3 days | 52 (50) | 244 (36) | 1.7 (1.1 to 2.8) | 0.02 |
Any non-antipseudomonal antibiotic | ||||
No | 20 (19.2) | 231 (34.1) | 1 | |
1 to 3 days | 20 (19.2) | 146 (21.5) | 1.6 (0.8 to 3) | 0.2 |
>3 days | 64 (61.5) | 301 (44.4) | 2.5 (1.4 to 4.2) | <0.001 |