A clinical index predicting mortality with Pseudomonas aeruginosa bacteraemia

Abstract

The aim of this study was to define risk factors associated with mortality in Pseudomonas aeruginosa bactaeremia and to combine them in a clinical index predicting the risk of death. The study investigated 125 consecutive episodes of P. aeruginosa bacteraemia at this hospital. Crude mortality was 34%, corresponding to 43 patients who died, with 67% of deaths, directly attributable to bacteraemia. A regression logistic model identified five variables that were independently and significantly associated with an increased risk of death: 1) hospitalisation in the intensive care unit; 2) coagulopathy; 3) septic shock; 4) age >65 years; and 5) the clinical condition of the patient. These variables were as recorded at the time that the first positive blood culture was obtained. The sensitivity and specificity of a prediction of death based on the model were 84% and 85%, respectively. An index score, calculated from these variables, divided patients into three groups with increasing likelihood of mortality resulting from P. aeruginosa bacteraemia.

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

“…age, presence of septic shock and low serum albumin levels [2,3,18]. There was a high frequency of inappropriate treatment, but this does not seem to have influenced the outcome.…”

“…The characteristics of the antimicrobial therapy were included as risk factors. The factors clearly related to death were the more classical ones, such as age, septic shock and serum albumin [2,17,18,19,20]. However, several therapy-related findings were curious, producing some surprising revelations.…”

“…Pseudomonas aeruginosa has evolving virulence characteristics and antimicrobial resistance patterns which make it a difficult target for antibiotic therapy [1][2][3]. It was the most frequently found bacterium in lower airway infections in Brazilian hospitals of the SENTRY study [4], displaying a resistance of 49% to imipenem and of 49.8% to ceftazidime.…”

Rats as possible agents of antibiotic resistant Pseudomonas aeruginosa transmission through poultry in Ibadan, Oyo State, Nigeria

“…Of all the infections by Gram negative bacteria, it has been noted for its high morbidity and mortalities particularly among critically ill and immune-compromised patients (Marshal et al, 1993;Andremont et al, 1989;Dantas and Moretti-Branchini, 2003;Aliaga et al, 2002). The mortalities is usually caused by increased in the rate of drug resistance especially to drug of choice for its treatment, like fluoroquilonones (Gasnik et al, 2006).…”

Ease with VITEK 2 systems, biomerieux in identification of non-lactose fermenting bacteria including their antibiotic drug susceptibility: our experience

“…Although frequently considered as contaminants, the pathogenic potential has been proved beyond doubt by their frequent isolation from clinical material and their association with disease. 1,2 NonFermenting Gram Negative Bacilli (NFGNB) are known…”