In-hospital mortality from healthcare-associated infection by multidrug-resistant Pseudomonas aeruginosa: a competing risks analysis of a 4-year propensity-matched cohort study in southern China
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: (MDRPa) pose enormous challenges in healthcare. We examined the incidence and relative mortality rates of patients with MDRPa HAI compared to non-MDRPa HAI in southern China. Methods: A hospital-wide longitudinal cohort study was conducted using prospectively collected surveillance data from 2018 to 2021. Poisson regression was applied to estimate incidence rate ratios (IRRs). Propensity-score matching and competing risks regression analysis (Fine-Gray model) were employed to estimate subdistribution hazard ratios (sHRs) for in-hospital mortality comparing MDRPa to non-MDRPa infections. Results: Among 562 patients studied (mean age 58 years, 74% male, in-hospital mortality 13.7%), 278 (49%) had an MDRPa HAI and 284 (51%) a non-MDRPa HAI. The incidence rate of MDRPa HAIs increased over time (mean monthly IRR: 1.016, 95% CI: 1.007-1.024). No significant difference in 14-day in-hospital mortality between MDRPa and non-MDRPa HAIs were detected in the propensity-matched doubly-robust analysis (adjusted sHR: 1.07, 95% CI: 0.52-2.19). However, MDRPa HAI was associated with a lower probability of 14-day discharge alive (adjusted sHR: 0.44, 95% CI: 0.31-0.63), resulting in longer hospital stays. Conclusions: The study provided real-world evidence of the clinical burden of MDRPa HAIs in China, highlighting their rising incidence and direct effect on prolonging hospitalisation. The findings underscore the need for antimicrobial stewardship interventions to ensure timely de-escalation and optimised antibiotic therapy.
Source: PubMed
DOI: 10.3205/dgkh000597
Authors: Zhou, Mouqing, Kritsotakis, Evangelos I., Xu, Baohua, Guo, Zhusheng, Zeng, Yongfeng, Zhou, Bin, Brinks, Ralph, Wang, Jiancong
Language: English
Subfield: Molecular Medicine
Domain: Life Sciences
Open Access status: green
OpenAlex ID: W7106304347