Volume 25, Number 7—July 2019
Synopsis
Carbapenem-Resistant Pseudomonas aeruginosa at US Emerging Infections Program Sites, 2015
, Julian E. Grass, Sandra N. Bulens, Emily B. Hancock, Erin C. Phipps, Daniel Muleta, Jackie Mounsey, Marion A. Kainer, Cathleen Concannon, Ghinwa Dumyati, Chris Bower, Jesse Jacob, P. Maureen Cassidy, Zintars Beldavs, Karissa Culbreath, Walter E. Phillips, Dwight J. Hardy, Roberto L. Vargas, Margret Oethinger, Uzma Ansari, Richard Stanton, Valerie Albrecht, Alison Laufer Halpin, Maria Karlsson, J. Kamile Rasheed, and Alexander Kallen
Table 3
Culture source, provider-reported infection type, and prior healthcare risk factors in incident carbapenem-resistant Pseudomonas aeruginosa cases, United States, July–October 2015
| Characteristic | No. (%) cases |
|---|---|
| Culture source | N = 294 |
| Any sterile site* | 21 (7.1) |
| Blood | 10 (47.6) |
| Internal abscess | 7 (33.3) |
| Pericardial fluid | 1 (4.8) |
| Peritoneal fluid | 1 (4.8) |
| Joint/synovial fluid | 1 (4.8) |
| Other normally sterile sites | 1 (4.8) |
| Nonsterile site† | 273 (92.9) |
| Respiratory‡ | 120 (44.0) |
| Urine | 111 (40.7) |
| Wound | 35 (12.8) |
| Other nonsterile sites |
9 (3.3) |
| Infection type§ | N = 268 |
| Urinary tract infection | 85 (31.7) |
| Pneumonia | 78 (29.1) |
| Septic shock | 20 (7.5) |
| Bacteremia | 20 (7.5) |
| Internal abscess | 11 (4.5) |
| Other infection types¶ | 57 (21.3) |
| >1 Infection type | 38 (14.2) |
| No infection |
35 (13.1) |
| Risk factors | |
| Any healthcare exposure, n = 280# | 257 (91.8) |
| Indwelling device placed <7 d before culture, n = 280 | 194 (69.3) |
| Surgery in prior year, n = 280 | 111 (39.6) |
| Long-term care facility resident in prior year, n = 280 | 84 (30.0) |
| Culture collected after hospital day 3, n = 280 | 64 (22.9) |
| Long-term acute care hospitalization in prior year, n = 280 | 40 (14.3) |
| Current chronic dialysis, n = 280 | 29 (10.4) |
| Hospitalization in prior year, n = 247 | 205 (83.0) |
| Antimicrobial drug <14 d before culture collection, n = 155** | 101 (65.2) |
*Includes 5 cases with CRPA from both sterile and nonsterile sites collected at time of incident culture (1 blood and tracheal aspirate; 1 blood and catheter tip; 1 blood and urine; 1 internal abscess and sputum; 1 pericardial fluid and wound).
†Total number of nonsterile sites is >273 because 2 case-patients had CRPA in multiple nonsterile sites at time of incident culture (1 sputum and tracheal aspirate; 1 urine and tracheal aspirate).
‡Includes sputum (n = 70), tracheal aspirate (n = 38), and bronchoalveolar lavage (n = 12).
§Total number of incident cases with completed case report form, excluding 13 cases with unknown infections.
¶Other infection types include the following: cellulitis (n = 9), decubitus/pressure ulcer (n = 7), chronic ulcer/wound (n = 6), bronchitis (n = 6), osteomyelitis (n = 6), surgical incision infection (n = 4), infection, not specified (n = 3), upper respiratory tract infection (n = 3), pyelonephritis (n = 2), cystic fibrosis exacerbation (n = 2), surgical site infection (n = 2), catheter site infection (n = 1), peritonitis (n = 1), skin abscess (n = 1), empyema (n = 1), septic arthritis (n = 1), wound (n = 1), other infection (n = 1).
#Total number of incident cases with completed case report form, excluding 1 case with unknown healthcare risk factors.
**Total number of incident cases with completed case report form and their culture collected in a short-stay or long-term acute care hospital.