Abstract：
BACKGROUND: Carbapenem-resistant strains of Pseudomonas aeruginosa (CRPA) have become a major healthcare concern in many countries, against which anti-infective strategies are limited and which require adequate infection control interventions. Knowing the different modes of transmission of CRPA in intensive care units (ICUs) would be helpful to adapt the means of prevention.
METHODS: The aim of this retrospective case-control study was conducted between 01/01/2017 and 02/28/2022 to identify the risk factors for the acquisition of CRPA in ICUs.
RESULTS: During the study period, 147 patients were included (49 cases and 98 controls). Among the 49 patients, 31 (63%) acquired CRPA in clusters and 18 (37%) sporadically. An univariate analysis showed that five variables were associated with CRPA acquisition including (i) prior antibiotic prescriptions, (ii) admission to rooms 203 and 207, (iii) severity of illness at admission, and (iv) use of mechanical ventilation. Multivariate analysis identified three factors of CRPA acquisition including admission to room 203 (OR = 29.5 [3.52-247.09]), previous antibiotic therapy (OR = 3.44 [1.02 - 11.76]) and severity of condition at admission (OR = 1.02 [1 - 1.04]).
CONCLUSIONS: Our study suggests the role of a contaminated environment in the acquisition of CRPA in the ICU, along with antibiotic use.
METHODS: The aim of this retrospective case-control study was conducted between 01/01/2017 and 02/28/2022 to identify the risk factors for the acquisition of CRPA in ICUs.
RESULTS: During the study period, 147 patients were included (49 cases and 98 controls). Among the 49 patients, 31 (63%) acquired CRPA in clusters and 18 (37%) sporadically. An univariate analysis showed that five variables were associated with CRPA acquisition including (i) prior antibiotic prescriptions, (ii) admission to rooms 203 and 207, (iii) severity of illness at admission, and (iv) use of mechanical ventilation. Multivariate analysis identified three factors of CRPA acquisition including admission to room 203 (OR = 29.5 [3.52-247.09]), previous antibiotic therapy (OR = 3.44 [1.02 - 11.76]) and severity of condition at admission (OR = 1.02 [1 - 1.04]).
CONCLUSIONS: Our study suggests the role of a contaminated environment in the acquisition of CRPA in the ICU, along with antibiotic use.
摘要：
背景：耐碳青霉烯的铜绿假单胞菌（CRPA）菌株已成为许多国家的主要医疗保健问题，抗感染策略有限，需要适当的感染控制干预措施。了解重症监护病房（ICU）中CRPA的不同传播方式将有助于调整预防手段。
方法：这项回顾性病例对照研究的目的是在2017年1月1日至2022年2月28日之间进行，以确定ICU中获得CRPA的风险因素。
结果：在研究期间，147例患者（49例，98例对照）。在49名患者中，31例（63%）成簇获得CRPA，18例（37%）零星获得CRPA。单变量分析表明，五个变量与CRPA获得相关，包括(I)先前的抗生素处方，(ii)入住203及207室，(iii)入住时病情严重程度，(iv)使用机械通气。多变量分析确定了CRPA获取的三个因素，包括进入203室（OR=29.5[3.52-247.09]），既往抗生素治疗(OR=3.44[1.02–11.76])和入院时病情的严重程度(OR=1.02[1–1.04]).
结论：我们的研究表明，污染环境在ICU获得CRPA中的作用，随着抗生素的使用。
方法：这项回顾性病例对照研究的目的是在2017年1月1日至2022年2月28日之间进行，以确定ICU中获得CRPA的风险因素。
结果：在研究期间，147例患者（49例，98例对照）。在49名患者中，31例（63%）成簇获得CRPA，18例（37%）零星获得CRPA。单变量分析表明，五个变量与CRPA获得相关，包括(I)先前的抗生素处方，(ii)入住203及207室，(iii)入住时病情严重程度，(iv)使用机械通气。多变量分析确定了CRPA获取的三个因素，包括进入203室（OR=29.5[3.52-247.09]），既往抗生素治疗(OR=3.44[1.02–11.76])和入院时病情的严重程度(OR=1.02[1–1.04]).
结论：我们的研究表明，污染环境在ICU获得CRPA中的作用，随着抗生素的使用。
