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American Journal of Epidemiology Vol. 128, No. 4: 821-827
Copyright © 1988 by The Johns Hopkins University School of Hygiene and Public Health

research-article

THE EPIDEMIOLOGY OF GENTAMICIN-RESISTANT PSEUDOMONAS AERUGINOSA ON AN INTERMEDIATE CARE UNIT

RODGER D. MACARTHUR1,, M. H. LEHMAN2, C. A. CURRIE-MCCUMBER2 and DAVID M. SHLAES3

1Department of Infectious Diseases, Blalock 1111, The Johns Hopkins Hospital 600 N. Wolfe Street, Baltimore, MD 21205
2Infectious Diseases Section and Research Service, Cleveland Veterans Administration Medical Center Cleveland, OH
3Infectious Diseases Section and Research Service, Cleveland Veterans Administration Medical Center and Case Western Reserve University School of Medicine Cleveland, OH

Send reprint requests to Dr. Rodger D. MacArthur at this address

The authors conducted a prospective six-month study of colonization by gentamicln-resistant Pseudomonas aeruginosa on an intermediate care unit at a Cleveland, Ohio hospltai with the use of selective culture techniques. serotyping, and plasmid analysis. Thirty-five of 163 patients (21%) were culture positive at least once for gentamlcln-resistant Pseudomonas aeruginosa. Patient samples, environmental cultures, and personnel hand cultures revealed no common source for the organisms. Plasmid profiling added little to the serotyping data. Only nonambulation and length of stay on the unit were significant independent risk factors for colonization with gentamicin-resistant Pseudomonas aeruginosa by multiple logistic regression analysis. Age, use of urinary catheters, exposure to antibiotics, and duration of antibiotic use were correlated with one or both of the independent risk factors, but were not themselves independently associated with colonization by these resistant organisms. Cross-colonization apparently was not an important mode of dissemination of gentamicin-resistant Pseudomonas aeruginosa on this intermediate care unit. The identified risk factors appear to be more important than cross-colonization, and control strategies should address these issues.

antibiotic resistance; plasmids; Pseudomonas aeruglnosa; regression analysis; serotyping


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