期刊
BMC INFECTIOUS DISEASES
卷 14, 期 -, 页码 -出版社
BMC
DOI: 10.1186/s12879-014-0650-9
关键词
XDR; Predictors of colonisation; IMP carbapenemase; VIM carbapenemase; Clinical risk score; Clinical score construction; Matched case-control study; Conditional logistic regression
资金
- German Center for Infection Research (DZIF)
- Deutsche Forschungsgemeinschaft
- Open Access Publishing Fund of Tuebingen University
Background: This study aimed to investigate risk factors for colonisation with extensively drug-resistant P. aeruginosa (XDR-PA) in immunocompromised patients and to build a clinical risk score (CRS) based on these results. Methods: We conducted a matched case-control study with 31 cases and 93 controls (1:3). Cases were colonised with XDR-PA during hospitalisation. Independent risk factors were determined using a three step conditional logistic regression procedure. A CRS was built with respect to the corresponding risk fraction of each risk factor, and its discriminatory power was estimated by receiver operating characteristic (ROC) analysis. Results: The presence of a central venous catheter (OR 7.41, P = 0.0008), the presence of a urinary catheter (OR 21.04, P < 0.0001), CRP > 10 mg/dl (OR 7.36, P = 0.0015), and ciprofloxacin administration (OR 5.53, P = 0.025) were independent risk factors. The CRS exhibited a high discriminatory power, defining a high risk population with an approximately fourteen times greater risk for XDR-PA colonisation. Conclusions: Unnecessary use of antibiotics, particularly ciprofloxacin should be avoided, and a high standard of infection control measures must be achieved when using medical devices. A CRS can be used for adaptation of the active screening culture policy to the local setting.
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