Multidrug-resistant strains of Pseudomonas aeruginosa (MDRPA) have been increasing in some hospitals [1] and may become a public health problem [2]. The emergence of MDRPA has been related to exposure to antibiotics against P. aeruginosa [3, 4]. Most of these studies have focussed on particular environments such as the intensive care unit (ICU) [5] or particular antibiotic resistances, mainly quinolone-resistant P. aeruginosa and carbapenem-resistant P. aeruginosa or specific infection sites such ventilator-associated pneumonia or bacteraemia [6, 7]. Most studies have used case-control methodology or have investigated outbreaks, and the case-control studies have usually compared susceptibility to resistant microorganisms. This methodology may overestimate the association between the resistance-defining antibiotic or may be falsely implicated as a potential risk factor for the acquisition of this pattern of susceptibility [8, 9].
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