<p>Risk Factors for Mortality of Inpatients with <em>Pseudomonas aeruginosa</em> Bacteremia in China: Impact of Resistance Profile in the Mortality</p>

Abstract

Purpose Pseudomonas aeruginosa bacteremia presents a severe challenge to hospitalized patients. However, to date, the risk factors for mortality among inpatients with P. aeruginosa bacteremia in China remain unclear. Patients and Methods This retrospective multicenter study was performed to analyze 215 patients with culture-confirmed P. aeruginosa bacteremia in five healthcare centers in China during the years 2012–2019. Results Of 215 patients with P. aeruginosa bacteremia, 61 (28.4%) died during the study period. Logistic multivariable analysis revealed that cardiovascular disease (OR=3.978, P =0.001), blood transfusion (OR=5.855, P <0.001) and carbapenem-resistant P. aeruginosa (CRPA) phenotype (OR=4.485, P =0.038) constituted the independent risk factors of mortality. Furthermore, both CRPA and multidrug-resistant P. aeruginosa (MDRPA) phenotypes were found to be significantly associated with 5-day mortality (Log-rank, P <0.05). Conclusion This study revealed a high mortality rate amongst hospitalized patients with P. aeruginosa bacteremia, and those with cardiovascular diseases, CRPA and MDRPA phenotypes, should be highlighted and given appropriate management in China.

Bloodstream Infections Caused by Carbapenem-Resistant Enterobacterales: Risk Factors for Mortality, Antimicrobial Therapy and Treatment Outcomes from a Prospective Multicenter Study

“…18 The mortality was higher than Pseudomonas aeruginosa bacteremia in China. 19 Many factors could affect the prognosis of patients, including individual risk factors, severity of illness, pathogen characteristics, and antimicrobial therapeutic effect. The severity of underlying diseases, as well as the presence of septic shock, are important in patient's prognosis.…”

It’s Not Easy Being Green: A Narrative Review on the Microbiology, Virulence and Therapeutic Prospects of Multidrug-Resistant Pseudomonas aeruginosa

“…Among bacterial pathogens responsible for contact lensassociated keratitis, P. aeruginosa has the worst disease manifestation (i.e., the development of a corneal ulcer, which may occur in 40-60% of cases), leading to poor outcomes, the fulminant destruction of the cornea, and vision loss [73,134,135]. The mortality rate of pseudomonad infections is a big concern among immunocompromised and hospitalized patients, which is around 25-39% for pneumonia and 18-61% for bacteremia, while these rates may be higher (40-70%) in case of MDR isolates [136][137][138]. In some age groups, these infections may have particularly severe manifestations (e.g., nosocomial pneumonia in the elderly, and severe sepsis and meningitis in neonates) [125][126][127][128][129][130][131][132][133][134][135][136][137].…”

No Correlation between Biofilm Formation, Virulence Factors, and Antibiotic Resistance in Pseudomonas aeruginosa: Results from a Laboratory-Based In Vitro Study

“…As a consequence, infections caused by MDR pathogens are associated with increased mortality rates and hospitalization costs, and decreased quality of life (QoL) in affected patients [ 19 ]. P. aeruginosa possesses intrinsic resistance to a wide range of antimicrobials, and due to its pronounced genomic plasticity and rich resistome, it has a particular propensity of acquire mechanisms of resistance (through horizontal gene transfer) to several, structurally-distinct antimicrobial drugs [ 9 , 20 ]. As a result, P. aeruginosa isolates with high-level resistance to fluoroquinolones, aminoglycosides, and carbapenems are increasingly common worldwide [ 21 ].…”