(44) Epidemiology of Pseudomonas and Multidrug-Resistant Pseudomonas Species in Patients Hospitalized with Community-Acquired Bacterial Pneumonia

Friday, August 26, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 375

Presenting Author(s)

Adeniyi J. Idigo, PhD, MPH, BPharm
– Dr., University of Alabama Birmingham, University of Alabama at Birmingham, Homewood, Alabama, United States

Co-Author(s)

J. Michael Wells, MD, MSPH
– MD, Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham School of Medicine, Alabama, Birmingham, AL, United States
Matthew L. Brown, PharmD
– Pharmacist, Department of Pharmacy, UAB Hospital, Birmingham, Alabama, Birmingham, AL, United States
Howard Wiener, PhD
– Statistician, Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Alabama, Birmingham, AL, United States
Russell Griffin, PhD
– Associate Professor, Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Alabama, Birmingham, AL, United States
Gary Cutter, PhD
– Emeritus Professor of Biostatistics, Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Alabama, Birmingham, AL, United States
Sadeep Shrestha, PhD
– Professor, Department of Epidemiology, University of Alabama at Birmingham, Alabama, Birmingham/Alabama, AL, United States
Rachael A. Lee, MD, MSPH
– MD, Department of Medicine, Division of Infectious Diseases, University of Alabama School of Medicine, Alabama, Birmingham, AL, United States

Background: Microbial etiology for community-acquired pneumonia (CAP) is evolving with pathogens known for high CAP mortality e.g., Pseudomonas species. Comorbidity with chronic obstructive pulmonary disease (COPD) increases the risk for hospitalization for CAP. Understanding regional patterns and risk factors for multidrug-resistant (MDR) Pseudomonas acquisition has implications for antimicrobial stewardship.

Objectives: To examine the relationship between Pseudomonas/MDR Pseudomonas CAP and COPD.

Methods: We queried the electronic medical records of patients hospitalized for CAP with Pseudomonas positive respiratory samples between 01/01/2013–12/31/2019. Log binomial regression models were used to examine associations between COPD diagnosis and risk of Pseudomonas/MDR Pseudomonas CAP.

Results: Cohort consisted of 913 culture positive CAP cases aged 59-year (IQR:48–68), 61% (560) male, 60% (547) white, 65% (580) current/past smokers, and 42% (384) COPD. Prevalence of Pseudomonas CAP in culture positive CAP was 18% (167), MDR Pseudomonas CAP in Pseudomonas CAP was 22% (36), and yearly incidence of MDR Pseudomonas CAP was stable (p = 0.169). COPD was associated with Pseudomonas CAP (RR:1.39; 95%CI: 1.01,1.91; p = 0.041) but not with MDR Pseudomonas CAP (0.71; 95%CI: 0.35,1.45; p = 0.349).

Conclusions: COPD was associated with Pseudomonas CAP but not with MDR Pseudomonas CAP. Clinical cohort studies with real-world data are useful in understanding the dynamics of resistance.