Clinical characteristics and predictors of community-acquired pseudomonas aeruginosa sepsis and nontyphoidal salmonella sepsis in infants: A matched Case–Control study

Abstract

Background: Pseudomonas aeruginosa and nontyphoidal Salmonella (NTS) species may cause enteric illness with sepsis in infancy. The clinical predictors distinguishing the two pathogens have not been comprehensively evaluated in this population in Taiwan. Methods: A retrospective matched caseecontrol study was conducted in a teaching hospital in southern Taiwan from January 1, 2003 to January 30, 2019. The patients with communityacquired P. aeruginosa sepsis were matched at a ratio of 1:2 by age and gender with controls (who developed NTS sepsis). Results: A total of 21 infants with community-acquired P. aeruginosa sepsis were identified; of these, 12 (57.1%) were male, and the mean AE standard deviation of age was 6.95 AE 2.47 months. Two independent predictors indicative of P. aeruginosa sepsis, as identified by multivariate analysis using conditional logistic regression, were hemoglobin level (Hb) (matched odds ratio [mOR], 0.155; 95% confidence interval [CI], 0.027e0.900; p Z 0.038) and platelet count (mOR, 0.988, 95% CI, 0.976e1.000; p Z 0.049). The areas under the receiver operating characteristic (ROC) curves of Hb and platelet count for P. aeruginosa sepsis prediction were 0.855 and 0.803, respectively. With cutoff values for Hb of 10.7 g/dL and platelet count of 173,000/mL, the predictors had maximal diagnostic accuracy.

Novel evidence on sepsis-inducing pathogens: from laboratory to bedside

“…An additional useful example that warrants attention is the protective effect observed for hemoglobin levels in P. aeruginosa pediatric sepsis as an outcome, with an astounding OR = 0.155 obtained after multivariate logistic regression analyses in a matched case-control study conducted in Taiwan (Kung et al, 2020). Extensive research has characterized the immune responses at the lung and skin in mouse models of acute P. aeruginosa infection but the role of both innate and adaptive immune cells during P. aeruginosa sepsis is still poorly understood.…”