Compared with patients who have carbapenem-susceptible Pseudomonas aeruginosa (CSPA) pneumonia, patients with carbapenem-resistant P aeruginosa (CRPA) pneumonia were more likely to be men and admitted from skilled nursing facilities and more often require mechanical ventilation, according to research findings presented at the American Society for Microbiology (ASM) Microbe 2019, held June 20-24, 2019 in San Francisco, California.
In this retrospective chart review, researchers compared P aeruginosa isolated from respiratory cultures from patients with CRPA with patients who had CSPA. The objective of the study was to compare risk factors and outcomes between the 2 groups.
The study included 37 patients with resistant pseudomonas infection (mean age, 67.8 years) and 37 with CSPA (mean age, 70.3 years). Compared with the CSPA group, there were more men in the CRPA group (73% vs 17%) and more were admitted from skilled nursing/long-term care facilities (86% vs 35%).
More patients with CRPA had a tracheotomy prior to admission (62% vs 24%; P =.002), required mechanical ventilation at the time of P aeruginosa isolation (54% vs 24%; P =.017), and longer median vasopressor use (15 vs 2 days; P =.016) and mechanical ventilation (15 vs 6 days; P =.004).
Further, more patients with CRPA were infected with strains of P aeruginosa that were also fluoroquinolone-resistant (81% vs 22%; P <.001). Patients with resistant pseudomonal infections also had a longer period before receiving effective treatment (2.33 vs 1.08 days; P =.001), and did not achieve clinical stability (59% vs 30%; P =.019). In addition, the CRPA group had a greater mean length of hospital stay (17.9 vs 11.8 days; P =.068) and 30-day mortality (30% vs 22%; P =.595).
Since CRPA pneumonia accounts for the majority of pseudomonal infections, the significant morbidity associated with it adds to the overall healthcare burden, concluded the researchers.
Kim EJ, Nieberg P, Huse H, Wong-Beringer A. Carbapenem-resistant Pseudomonas aeruginosa pneumonia: risk factors for acquisition and impact on outcomes. Presented at: ASM Microbe 2019; June 20-24, 2019; San Francisco, California. Poster 580.