Risk Factors Associated With Bacteremia Due to Multi-Drug Resistant Pseudomonas Aeruginosa In a Pediatric Tertiary Referral Hospital in Mexico City

Background: The incidence of multi-drug resistant P. aeruginosa (MDR-PA) has increased in recent years. There is an association between antimicrobial resistance and the increased in mortality and prolonged hospitalization.

Objective: To identify risk factors associated with the acquisition of bacteremia due to MDR-PA in pediatric patients

Methods: We performed a retrospective case -control study from 2012 to 2018 in Hospital Infantil de México Federico Gómez in Mexico City. Cases: patients with positive cultures for MDR-PA. Controls: patients with cultures positive for P. aeruginosa susceptible to at least 3 groups of antibiotics. To assess for possible risk factors we perform crosstabs and calculation of odds ratio (OR). A multiple logistic regression model was conducted with significant variables.

Results: We analyzed 130 subject (46 cases and 84 controls). Mean age 6.6 years. The Most frequent basal condition was oncologic (42%) and the most frequent diagnosis septic shock (53%). Cephalosporins (56%) was the previous antibiotic more frequently used before the event of bacteremia by MDR-PA. Meropenem was the antibiotic most used as empirical treatment (58.4%).: Previous use of broad spectrum antibiotics (OR 8.2, 95% CI 1.86 - 36.65, p <0.01) and previous stay in PICU (OR 4.9, 95% CI 1.21- 20.39, p <0.01) were associated to bacteremia due to MDR-PA.. There were more cases of complication in the group of MDR-PA bacteremia: septic shock (97.8%, P <0.01) and admission to UTIP (63.3%

Conclusion: In our population, risk factors for acquisition of bacteremia due to MDR-PA were previous use of antibiotics and previous stay in PICU. Mortality from bacteremia due to MDR-PA was high (51.8%).