Risk factors for hospital-acquired pneumonia caused by carbapenem-resistant Gram-negative bacteria in critically ill patients: a multicenter study in Korea

• DOI: 10.1016/j.diagmicrobio.2013.08.011
• Publication Date: 2014-01-24T02:15:23Z
• Authors: Tark Kim; Yong Pil Chong; Seong Yeon Park; Min-Hyok Jeon; Eun Joo Choo; Jin-Won Chung; Hyun Kyung Lee; Chisook Moon; Dong-Min Kim; Kyong Ran Peck; Yang Soo Kim
• Keywords: Male; 0301 basic medicine; Cross Infection; Critical Illness; Middle Aged; beta-Lactam Resistance; Anti-Bacterial Agents; 3. Good health; 03 medical and health sciences; Carbapenems; Risk Factors; Gram-Negative Bacteria; Republic of Korea; Pneumonia, Bacterial; Humans; Female; Gram-Negative Bacterial Infections; Aged; Retrospective Studies

We performed a case-control study to identify risk factors of carbapenem-resistant Gram-negative bacteria (CRGNB) as an increasing cause of hospital-acquired pneumonia (HAP). The study included critically ill adult patients with HAP whose microbial etiology was identified at eight tertiary centers in Korea between June 2008 and December 2009. Eighty two patients with 86 isolates of CRGNB (62 Acinetobacter baumannii, 14 Pseudomonas aeruginosa, and 10 Stenotrophomonas maltophilia) were included in the case group, and 122 patients with carbapenem-susceptible Gram-negative bacteria were included in the control group. Diabetes mellitus (adjusted odds ratio [aOR] 2.82, 95% confidence interval [95% CI] 1.25-6.38), radiologic score ≥5 (aOR 4.56, 95% CI 2.36-8.81), prior fluoroquinolone (aOR 2.39. 95% CI = 1.07-5.35), or carbapenem usage (aOR 2.82, 95% CI 1.75-17.83) were found to be independent risk factors. Fluoroquinolone and carbapenem should be cautiously used to avoid HAP caused by CRGNB.