Risk Factors of Pseudomonas aeruginosa Infection in Neonatal Intensive Care Unit and Pediatric Intensive Care Unit: A Matched Case–Control Study

Introduction: Pseudomonas aeruginosa ( P. aeruginosa ) is a nonfermentative Gram-negative rod that has been associated with nosocomial infections. Many factors were found to increase the risk of acquiring P. aeruginosa infection in the neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU). Hence, our study aims to evaluate the risk factors of acquired P. aeruginosa infection or colonization after NICU and PICU admissions. Methods: This study is a matched retrospective case–control study. Cases included all pediatric patients diagnosed with P. aeruginosa infection or colonization who met the specified criteria. For each case, two controls (1:2 basis) who were negative for P. aeruginosa infection were randomly selected. Results: During the study period, a total of 31 confirmed cases of Pseudomonas bacteremia infection or colonization were identified and were matched with 62 controls. Most cases and control group’s ages are between 0 and 1 month, with proportions of 71.7% and 72.6%, respectively. The gender distribution was not significantly different in the two groups. Respiratory distress syndrome ( P = 0.004), sepsis ( P = 0.001), malnutrition ( P = 0.005), heart diseases ( P = 0.001, odds ratio = 10.88), and neurological diseases ( P = 0.021) were significantly associated with Pseudomonas identification. Multidrug-resistant P. aeruginosa isolates among cases was only reported in two cases. In univariate analysis, the factors of congenital heart disease (CHD) and NICU/PICU stay duration were identified as significant factors. Multivariate analysis showed significant results in sepsis 6.44 (95% confidence interval [CI]: 1.39–29.7, P < 0.05), CHDs 6.89 (95% CI: 1.62–29.3, P < 0.01), malnutrition 3.64 (95% CI: 1.02–13.2, P < 0.05), and surgery history 4.02 (95% CI: 1.02–15.7, P < 0.05). Conclusion: More studies need to be conducted to evaluate both risk factors and drug resistance as the diagnostics and characteristics of the organisms are developing.