Risk factors for community-associated multidrug-resistant Pseudomonas aeruginosa in veterans with spinal cord injury and disorder: a retrospective cohort study

Study design: Retrospective cohort study Objectives: To identify independent risk factors associated with community-associated multidrug-resistant Psedomonas aeruginosa (MDRPA) in a population of veterans with spinal cord injury and disorders (SCI/D). Setting: A total of 127 Veterans Affairs healthc...

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Bibliographic Details
Published in:	Spinal cord Vol. 55; no. 7; pp. 687 - 691
Main Authors:	Kale, I O, Fitzpatrick, M A, Suda, K J, Burns, S P, Poggensee, L, Ramanathan, S, Sabzwari, R, Evans, C T
Format:	Journal Article
Language:	English
Published:	London Nature Publishing Group UK 01-07-2017 Nature Publishing Group
Subjects:	13/106 692/499 692/699/255/1318 Adolescent Adult Age Factors Aged Anatomy Biomedical and Life Sciences Biomedicine Carbapenems Cohort analysis Communities Confidence intervals Disorders Drug Resistance, Multiple, Bacterial Exposure Female Health care Health risk assessment Hospitals, Veterans Human Physiology Humans Male Middle Aged Multidrug resistance Multidrug resistant organisms Multivariate Analysis Neurochemistry Neuropsychology Neurosciences Odds Ratio original-article Paraplegia Pseudomonas aeruginosa Pseudomonas aeruginosa - drug effects Pseudomonas Infections - complications Pseudomonas Infections - epidemiology Resistance factors Retrospective Studies Risk analysis Risk Factors Spinal cord injuries Spinal Cord Injuries - complications Spinal Cord Injuries - epidemiology Spinal Cord Injuries - microbiology United States United States Department of Veterans Affairs Veterans
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Summary:	Study design: Retrospective cohort study Objectives: To identify independent risk factors associated with community-associated multidrug-resistant Psedomonas aeruginosa (MDRPA) in a population of veterans with spinal cord injury and disorders (SCI/D). Setting: A total of 127 Veterans Affairs healthcare facilities. Methods: Laboratory results from 1 January 2012 to 31 December 2013 were collected, and MDRPA cultures were compared with non-MDRPA cultures. Results: One thousand four hundred forty-one cultures were collected from Veterans with SCI/D, including 227 cultures with MDRPA isolates. Characteristics associated with an increased odds of MDRPA include age 50–64 (adjusted odds ratio (aOR)=1.80, 95% confidence interval (CI)=1.13–2.87), MDRPA culture in the past 365 days (aOR=9.12, 95% CI=5.88–14.15) and carbapenem exposure in the past 90 days (aOR=2.56, 95% CI=1.35–4.87). In contrast, paraplegia was associated with a 53% decreased odds of MDRPA compared with those with tetraplegia (aOR=0.47, 95% CI=0.32–0.69). Conclusions: Risk factors for community-associated MDRPA include prior history of MDRPA and exposure to carbapenems. Awareness of these factors is important for targeted prevention and treatment of MDRPA in patients with SCI/D.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1362-4393 1476-5624
DOI:	10.1038/sc.2017.7