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  1. Victoria Connor
  1. Respiratory Research Group, Liverpool School of Tropical Medicine, Liverpool, UK
  1. Correspondence to Dr Victoria Connor, Respiratory Research Group, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK; victoria.connor{at}lstmed.ac.uk

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Pseudomonas aeruginosa-community acquired pneumonia: international prevalence and risk factors

Community acquired pneumonia (CAP) is a major cause of morbidity and mortality worldwide. The contribution of Pseudomonas aeruginosa to both disease burden and antibiotic resistance is unclear; Restrepo et al (European Respiratory Journal 2018;52: 1701190) present a point-prevalence study to address this gap in the data. This multinational study of hospitalised patients investigated the prevalence, risk factors and antibiotic resistance profiles of P. aeruginosa-CAP in 54 countries. A total of 3193 patients were included, all had microbiological testing on admission and had a confirmed diagnosis of CAP. Prevalence of P. aeruginosa-CAP was 4.2 % (133/3193) which represented 11.3 % (133/1173) of all patients with a positive bacterial culture result. Almost half of these patients had an antibiotic-resistant strain (64/133, 48 %; 2.0 % of total cohort) and a quarter had a multi-drug resistant strain of P. aeruginosa (33/133, 25 %; 1.0 % of total cohort). Prior Pseudomonas infection/colonisation (OR 16.10, 95% CI 9.48 to 27.35), prior tracheostomy (OR 6.50, 95% CI 2.61 to 16.19), bronchiectasis (OR 2.88, 95% CI 1.65 to 5.05), patients requiring invasive respiratory and/or vasopressor support (OR 2.33, 95% CI 1.44 to 3.78) and very severe chronic obstructive pulmonary disease (COPD) (OR 2.67, 95% CI 1.25 to 6.06) were all independent risk factors associated with the development of P. aeruginosa-CAP. The …

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