Risk Factors of Pseudomonas Aeruginosa Infection in NICU and PICU: A Matched Case Control Study

Introduction: Pseudomonas aeruginosa (P. aeruginosa) is a non- fermentative gram-negative rod that has been associatedwith nosocomial infections. Many factors were found to increase the risk of acquiring P. aeruginosa infection in neonatal andpediatric intensive care units. Hence, our study aims to evaluate the risk factors of acquired Pseudomonas aeruginosa infection or colonization after NICU and PICU admission at King Abdulaziz Medical City, in Jeddah, Saudi Arabia.Method: This study is a matched retrospective case-control study conducted at King Abdulaziz Medical City (KAMC), Jeddah.Cases included all pediatric patients diagnosed with P. aeruginosa infection or colonization who met the specified criteria. Foreach 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 wereidentified and were matched with 62 controls. Most cases and control group's ages are between 0-1 month, with proportions of71.7% and 72.6 %, respectively. The gender distribution was not significantly different in the two groups. Respiratory distresssyndrome (p= 0.004), sepsis (p= 0.001), malnutrition (p= 0.005), heart diseases (p= 0.001 or= 10.88), neurological diseases (p=0.021) were significantly associated with Pseudomonas identification. MDR P. aeruginosa isolates among cases was only reported in two cases. In univariate analysis, the factors of congenital heart disease and NICU/PICU stay duration were identified as significant factors. Multivariate analysis showed significant results in sepsis 6.44 (95% CI: 1.39-29.7, P < 0.05), congenital heartdiseases 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 andcharacteristics of the organisms are developing.