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Background    Pseudomonas aeruginosa  is an opportunistic pathogen that frequently causes hospital acquired colonization and infection. Accurate identification of host and bacterial factors associated with infection could aid treatment decisions for patients with  P. aeruginosa  cultured from clinical sites.    Methods  We identified a prospective cohort of 248 hospitalized patients with positive  P. aeruginosa  cultures. Clinical data were analyzed to determine whether an individual met predefined criteria for infection versus colonization.  P. aeruginosa  isolates were tested for the expression of multiple phenotypes previously associated with virulence in animal models and humans. Logistic regression models were constructed to determine the degree of association between host and bacterial factors with  P. aeruginosa  infection of the bloodstream, lung, soft tissue and urinary tract.    Results  One host factor (i.e. diabetes mellitus), and one bacterial factor, a Type 3 secretion system positive phenotype, were significantly associated with  P. aeruginosa  infection in our cohort. Subgroup analysis of patients with  P. aeruginosa  isolated from the urinary tract revealed that the presence of a urinary tract catheter or stent was an additional factor for  P. aeruginosa  infection.    Conclusions  Among hospitalized patients with culture-documented  P. aeruginosa,  infection is more likely to be present in those with diabetes mellitus and those harboring a Type 3 secretion positive bacterial strain.

The Ability of Virulence Factor Expression by Pseudomonas aeruginosa to Predict Clinical Disease in Hospitalized Patients