Impact of antibiotic treatment and predictors for subsequent infections in multidrug-resistant Pseudomonas aeruginosa catheter-associated asymptomatic bacteriuria.

Abstract

Background: The rate of antibiotic treatment for catheter-associated asymptomatic bacteriuria (CA-ASB) remains high.

Methods: We conducted a retrospective study involving hospitalized patients with multidrug-resistant Pseudomonas aeruginosa (MDRP) CA-ASB. Cox proportional hazards regression models were used to identify predictors for subsequent symptomatic infections in patients with MDRP CA-ASB. The probability of remaining free from symptomatic infection was analyzed using Kaplan-Meier curves.

Results: The study cohort comprised 139 patients with MDRP CA-ASB. Subsequent symptomatic MDRP infections were observed in 37 (26.6%) patients. Multivariate analysis revealed that underlying urologic diseases (hazard ratio [HR]=2.17, 95% confidence interval [CI]=1.01-4.66, P=.047), active antibiotic treatment for MDRP (HR=2.34, 95% CI=1.02-5.38, P=.046), and recurrent bacteriuria (HR=3.57, 95% CI=1.73-7.38, P=.001) were independent predictors for subsequent symptomatic infections. The Kaplan-Meier analysis demonstrated a significantly lower cumulative proportion of symptomatic infection-free patients among those receiving active antibiotic therapy for MDRP CA-ASB than among those who did not (41.7% vs 76.4%, P=.006, log-rank test).

Conclusions: These findings support the current guidelines against routine antibiotic therapy, even for MDRP CA-ASB, and emphasize the need for close monitoring and timely intervention in high-risk populations.