Impact of Multidrug-resistant Pseudomonas aeruginosa Infection on Patient Outcomes

Elizabeth B Hirsch; Vincent H Tam


Expert Rev Pharmacoeconomics Outcomes Res. 2010;10(4):441-451. 

In This Article

Risk Factors for MDR P. aeruginosa Infection

As the prevalence of MDR P. aeruginosa has increased over the past few decades, many studies have focused on the specific risk factors associated with the isolation of MDR P. aeruginosa. Again, direct comparison of these papers is difficult owing to the varied definitions used for multidrug resistance. When focusing on case–control studies using more stringent definitions of multidrug resistance (i.e., resistance to multiple classes of antipseudomonal antimicrobials), prior to use of antibiotics (duration and number of classes),[34–38] history of P. aeruginosa infection or colonization within the previous year,[34] length of hospital stay,[38] being bedridden or in the ICU,[35] mechanical ventilation,[38] malignant disease,[35] and history of chronic obstructive pulmonary disease[34] have all been identified as independent risk factors for MDR P. aeruginosa infection. When looking specifically at antibiotics associated with the isolation of MDR P. aeruginosa, prior to receipt of carbapenems, broad-spectrum cephalosporins, aminoglycosides and fluoroquinolones have been identified as independent risk factors.[34–37] Hence, patients with MDR infections tend to be critically ill or have prolonged hospital stays and receive multiple antimicrobials (typically with antipseudomonal activity) prior to the isolation of MDR P. aeruginosa.