Risk factors for healthcare-associated infections caused by cefepime-resistant Pseudomonas aeruginosa

Introduction: The increasing resistance of Pseudomonas aeruginosa against cefepime requires a better understanding of hospital epidemiology in order to retain this drug as a therapeutic option. Aim: The aim of this study was to identify risk factors associated with healthcare associated infections (HAIs) caused by cefepime-resistant P. aeruginosa (CRPA), both in all patients with HAIs and in the subgroups of patients who died or who acquired infection with carbapenem-resistant P. aeruginosa. Methods: The academic study was designed as a combination of three nested case/ control studies within the cohort of patients with HAIs caused by P. aeruginosa regardless of localization, prospectively followed from January 2009 to December 2017 in a tertiary care hospital. The influence of risk factors on specific outcomes was estimated by adjusted odds ratios calculated from multivariate logistic regressions. Results: Our study showed that there are independent risk factors for CRPA infections: the existence of another HAI (p=0.001), hospitalization in ICU longer than one month (p=0.007), a longer stay in hospital prior to infection (p=0.004), longer use of mechanical ventilation (p=0.036), administration of antibiotics before infection (p