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Antimicrobial Agents and Chemotherapy, September 2005, p. 3663-3667, Vol. 49, No. 9
0066-4804/05/$08.00+0     doi:10.1128/AAC.49.9.3663-3667.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Risk Factors for Acquisition of Multidrug-Resistant Pseudomonas aeruginosa Producing SPM Metallo-ß-Lactamase

Simone Aranha Nouér,1 Marcio Nucci,1 Márcia P. de-Oliveira,1 Flávia Lúcia Piffano Costa Pellegrino,2 and Beatriz Meurer Moreira2*

Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Brazil,1 Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil2

Received 14 March 2005/ Returned for modification 30 May 2005/ Accepted 13 June 2005

To evaluate risk factors for colonization or infection due to multidrug-resistant Pseudomonas aeruginosa (MDRPa) carrying the blaSPM gene (SPM-MRDPa) among hospitalized patients, we undertook a case control study at a 480-bed, tertiary-care university hospital. Two different case definitions were used. In the first definition, a case patient (SPM case patient) was defined as a patient who had at least one isolate of SPM-MDRPa (14 patients). In the second, a case patient (non-SPM case patient) was defined as a patient who had at least one isolate of non-SPM-MDRPa (18 patients). For each case patient, we selected two controls, defined as a patient colonized and/or infected by a non-MDRPa isolate during the same study period and with the closest duration of hospitalization until the isolation of P. aeruginosa as cases. The use of quinolones was the single independent predictor of colonization and/or infection by blaSPM MDRPa (odds ratrio [OR] = 14.70, 95% confidence interval [95% CI] = 1.70 to 127.34, P = 0.01), whereas the use of cefepime was the single predictor of colonization and/or infection by non-blaSPM MDRPa (OR = 8.50, 95% CI = 1.51 to 47.96, P = 0.01). The main risk factor for MDRPa was a history of antibiotics usage. Stratification of risk factor analysis by a precise mechanism of resistance led us to identify a specific antibiotic, a quinolone, as a predictor for SPM-MDRPa.

* Corresponding author. Mailing address: Instituto de Microbiologia Professor Paulo de Góes, Bloco I, Laboratório I2-28, Centro de Ciências da Saúde, Cidade Universitária, Rio de Janeiro CEP 21941-590, Brazil. Phone: 55-21-22604193. Fax: 55-21-25608344. E-mail: bmeurera{at}alternex.com.br.

Antimicrobial Agents and Chemotherapy, September 2005, p. 3663-3667, Vol. 49, No. 9
0066-4804/05/$08.00+0     doi:10.1128/AAC.49.9.3663-3667.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



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