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.
Objectives. To establish and evaluate the analytical and clinical performance of the Flash20 SARS-CoV-2 nucleic acid rapid detection system free of RNA extraction. Methods. The limit of detection (LoD) was determined using a negative nasopharyngeal swab matrix spiked with different concentrations of SARS-CoV-2 virus; a total of 734,337 reference sequences of viral genomes from GenBank were used for the in-silico analysis to assess the inclusivity of the assay. The specificity of the system was evaluated by testing 27 medically relevant organisms. A total of 115 clinical specimens were collected and tested on the Flash20 SARS-CoV-2 detection system and with an FDA-approved comparator test to assess the clinical performance of the system. Results. The LoD of the Flash20 SARS-CoV-2 detection system is 250 copies/mL with a positive rate ≥90% (n = 20); alignments results showed that over 99% identity of the primer and probe of the Flash20 SARS-CoV-2 nucleic acid rapid detection system to the available SARS-CoV-2 sequences; the omicron samples tested 100% positive. None of the 27 organisms showed cross-reactivity with the Flash20 SARS-CoV-2 nucleic acid rapid detection system. Among all the 215 clinical samples, the Flash20 SARS-CoV-2 nucleic acid rapid detection system exhibits a high sensitivity of 99.24% (131/132) and 100% (83/83) specificity. Conclusion. The nucleic acid rapid detection system provides sensitive and accurate detection of SARS-CoV-2 free of RNA extraction. The high sensitivity and short time to results of approximately 35 minutes may impact earlier infection control and disease management.
Handling the infections by extensively drug-resistant
Pseudomonas aeruginosa
(XDRPA) strains is challenging due to their complicated antibiotic resistance mechanisms in immunosuppressed patients with pulmonary diseases (e.g., cystic fibrosis, chronic obstructive pulmonary disease, and lung transplant), ventilator-associated pneumonia, and bloodstream infections. The current study suggested the potentiality of the ceftazidime-avibactam-imipenem combination against XDRPA with
bla
AmpC
overexpression or mutation, decreased OprD porin, and/or upregulated efflux pumps.
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