Burden and risk factors forPseudomonas aeruginosacommunity-acquired pneumonia: a multinational point prevalence study of hospitalised patients

Pseudomonas aeruginosais a challenging bacterium to treat due to its intrinsic resistance to the antibiotics used most frequently in patients with community-acquired pneumonia (CAP). Data about the global burden and risk factors associated withP. aeruginosa-CAP are limited. We assessed the multinational burden and specific risk factors associated withP. aeruginosa-CAP. We enrolled 3193 patients in 54 countries with confirmed diagnosis of CAP who underwent microbiological testing at admission. Prevalence was calculated according to the identification ofP. aeruginosa. Logistic regression analysis was used to identify risk factors for antibiotic-susceptible and antibiotic-resistantP. aeruginosa-CAP. The prevalence ofP. aeruginosaand antibiotic-resistantP. aeruginosa-CAP was 4.2% and 2.0%, respectively. The rate ofP. aeruginosaCAP in patients with prior infection/colonisation due toP. aeruginosaand at least one of the three independently associated chronic lung diseases (i.e.tracheostomy, bronchiectasis and/or very severe chronic obstructive pulmonary disease) was 67%. In contrast, the rate ofP. aeruginosa-CAP was 2% in patients without priorP. aeruginosainfection/colonisation and none of the selected chronic lung diseases. The multinational prevalence ofP. aeruginosa-CAP is low. The risk factors identified in this study may guide healthcare professionals in deciding empirical antibiotic coverage for CAP patients.