Risk factors for infections with multidrug-resistant Pseudomonas aeruginosa in patients with cancer

Authors

  • Norio Ohmagari M.D.,

    1. Division of Infectious Diseases, Shizuoka Cancer Center, Shizuoka, Japan
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  • Hend Hanna M.D., M.P.H.,

    Corresponding author
    1. Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
    • Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 402, Houston, TX 77030
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    • Fax: (713) 792-8233

    • Dr. Hanna has received grant support from Wyeth and Astra-Zeneca.

  • Linda Graviss B.S.,

    1. Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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  • Brenda Hackett M.P.H.,

    1. Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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  • Cheryl Perego B.S., M.P.H.,

    1. Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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  • Virginia Gonzalez B.S.,

    1. Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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  • Tanya Dvorak B.S.,

    1. Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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  • Holly Hogan Pharm.D.,

    1. Department of Pharmacy, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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  • Ray Hachem M.D.,

    1. Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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  • Kenneth Rolston M.D.,

    1. Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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    • Dr. Rolston is on the Speakers' Bureau for Wyeth and Astra-Zeneca. He has received grant support from and is on the Speakers' Bureau for Elan, Pfizer, Merck, Bayer, and Bristol Myers-Squibb.

  • Issam Raad M.D.

    1. Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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    • Dr. Raad has received grant support and is on the Speakers' Bureau for Pfizer, Elan, Merck, and Wyeth.


Abstract

BACKGROUND

Pseudomonas aeruginosa is responsible for a wide range of infections. In immunocompromised patients with cancer, the emergence of multidrug resistant P. aeruginosa may have grave consequences.

METHODS

Patients with cancer who were infected with multidrug-resistant P. aeruginosa with polyclonal DNA restriction patterns were used as the case group. Two control groups were used: one group of cancer patients who were infected with multidrug-susceptible P. aeruginosa and another group of cancer patients who had the same underlying disease and the same intensive care unit exposure as patients in the case group but who were not infected or colonized by P. aeruginosa.

RESULTS

Risk factors that were associated significantly with multidrug-resistant P. aeruginosa infection were the use of carbapenem for ≥ 7 days, a history of P. aeruginosa infection during the preceding year, and a history of chronic obstructive pulmonary disease (P < 0.01).

CONCLUSIONS

Carbapenems may need to be used more judiciously as first-line empirical therapy for cancer patients with prior pseudomonal infection or chronic obstructive pulmonary disease who require hospitalization, and alternative, antipseudomonal antibiotic regimens may need to be considered, especially in this patient population. Cancer 2005. © 2005 American Cancer Society.

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