RISK FACTOR ASSESSMENT FOR THE ACQUISITION OF FLUOROQUINOLONE-RESISTANT ISOLATES OF PSEUDOMONAS-AERUGINOSA IN A COMMUNITY-BASED HOSPITAL

A case-control study was performed in a community-based nonteaching ho spital to assess patient risk factors for the acquisition of fluoroqui nolone-resistant isolates of Pseudomonas aeruginosa. Fifty-five patien ts who were hospitalized between July 1, 1993 and December 31, 1993 an d who had P. aeruginosa recovered from a clinical specimen were includ ed in the analysis. Two patient populations were designated based on t he fluoroquinolone susceptibility of their P. aeruginosa isolates. Sta tistical evaluation using univariate analysis of demographic and clini cal data from the 42 patients with quinolone-susceptible P. aeruginosa and the 13 patients with quinolone-resistant P. aeruginosa demonstrat ed that prior receipt of a fluoroquinolone was the only significant ri sk factor for the subsequent emergence of fluoroquinolone resistance a mong P. aeruginosa isolated from patients hospitalized in this small c ommunity-based institution (p = 0.0196), Multivariate analysis support ed the finding that prior receipt of a fluoroquinolone was the major r isk factor for the isolation of fluoroquinolone-resistant P. aeruginos a (p = 0.0004); isolation of this Gram-negative bacillus from sputum ( p = 0.0306) and a history of recent surgery (p = 0.0058) were also sig nificantly associated as risk factors for resistance.