Pseudomonas aeruginosa bacteraemia in patients with hematologic malignancies: risk factors, treatment and outcome

Diagn Microbiol Infect Dis. 2017 Aug;88(4):335-341. doi: 10.1016/j.diagmicrobio.2017.05.003. Epub 2017 May 11.

Abstract

Our aims were to identify factors associated with Pseudomonas aeruginosa (PA) bloodstream infection (BSI) in patients with hematological malignancies and evaluate the outcome of the affected patients. Consecutive patients with hematological malignancies who developed PA BSI were identified. Subsequently, two case-control studies were performed to evaluate the risk factors (i) for PA BSI and (ii) for carbapenem resistant (CR) PA BSI. Patients' outcome was evaluated at 28 days after the onset of bacteraemia. A total of 64 patients with PA BSI (45 caused by CS and 19 by CR organisms) and 128 without PA BSI were enrolled. Patients with rapidly fatal disease, steroid use, neutropenia or prior surgery were more likely to develop PA BSI, whereas patients with previous hospitalization and prior use of fluoroquinolones were more likely to develop CR PA BSI. The 28-day mortality rate was 35.9%. Severity of sepsis was the only independent predictor of adverse outcome.

Keywords: Bacteremia; Hematologic malignancy; Outcome; Pseudomonas; Risk factors.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia / drug therapy*
  • Bacteremia / microbiology
  • Carbapenems / therapeutic use
  • Case-Control Studies
  • Drug Resistance, Bacterial / drug effects
  • Female
  • Fluoroquinolones / therapeutic use
  • Hematologic Neoplasms / microbiology*
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Pseudomonas Infections / drug therapy*
  • Pseudomonas Infections / microbiology
  • Pseudomonas aeruginosa / drug effects*
  • Risk Factors
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • Fluoroquinolones