Pseudomonas aeruginosa bacteremia: An analysis of 123 episodes, with particular emphasis on the effect of antibiotic therapy

Abstract

Incidence, epidemiology, clinical characteristics, and outcome of pseudomonas sepsis did not change significantly over the past 2 decades. Appropriate monotherapy was as effective as combination drug therapy for individuals with pseudomonas bacteremia surviving the first 2 days of infection.

A clinical index predicting mortality with Pseudomonas aeruginosa bacteraemia

“…However, the present study, like other large series from the literature underlined the importance of nosocomial acquisition [2,[4][5][6][7][8][9][10][11]: 88% of our patients developed the infection in hospital. As in other series [3,4,11], preceding procedures and therapies were common in the patients in the present study, and are indicative of the number and severity of concomitant illnesses seen in these patients.…”

“…aeruginosa bacteraemia accounted for 1.06 episodes per 1000 admissions at this institution from Jan. 1996 to Dec. 1998. This prevalence is lower than that published in previous series [2,3,5,6,8,9], with the exception of that reported by Vázquez and colleagues in which the incidence of pseudomonas bacteraemia was 0.7 episodes per 1000 admissions [17]. This differential may reflect, at least in part, a current trend of decreasing incidence of P. aeruginosa infection among selected categories of immunocompromised patients [1,11].…”

“…It is frequently hospital-acquired and may be polymicrobial in nature [1,2]. Despite all the advances in medical practice in recent years, pseudomonal bacteraemia continues to have a high associated mortality, ranging from 18% to 61% [2][3][4][5][6][7][8][9][10][11]. Therefore, investigators have attempted to define those factors that influence the outcome of this infection.…”

“…These analyses have emphasised the deleterious impact of underlying diseases [3,8,10], septic shock [2,5,6,8,10,11] and the development of septic metastasis [2,5,6] on the outcome of bacteraemia. The availability of potent antimicrobial agents as well as high technology support for therapy of P. aeruginosa bacteraemia has barely modified the mortality rate [9]. Factors frequently associated with higher mortality from bacteraemia include certain sources and patient types, particularly those with pneumonia [2-6, 8, 11], neutropenia [2][3][4][5][6]11] and inappropriate antibiotic therapy [2, 4-7, 10, 11].…”

Pseudomonas aeruginosa infections: factors relating to mortality with emphasis on resistance pattern and antimicrobial treatment

“…Nor did we find any differences in outcome from infections in the presence of immunosuppression. On the other hand, combination therapy was used more often in cases of infection of the bloodstream, generally relating to bacteremia, and thus with a greater risk of death [1,8,23,24]. Moreover, since aminoglycosides were the antimicrobial agents most used in associations and, over the period of this study there was no consensus regarding their use for limited periods, the cause of death could be attributable to their adverse effects.…”