A retrospective analysis of Pseudomonas aeruginosa bloodstream infections: prevalence, risk factors, and outcome in carbapenem-susceptible and -non-susceptible infections
Abstract Background Pseudomonas aeruginosa (PA) is a leading cause of nosocomial infections, and carbapenem non-susceptible strains are a major threat to patient safety. Methods A single center, retrospective comparative analysis of carbapenem-non-susceptible PA (CnSPA) and carbapenem-susceptible PA...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2019-04-01
|
Series: | Antimicrobial Resistance and Infection Control |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s13756-019-0520-8 |
id |
doaj-7de13e759a004bcf98a2506e40be312b |
---|---|
record_format |
Article |
spelling |
doaj-7de13e759a004bcf98a2506e40be312b2020-11-25T02:01:33ZengBMCAntimicrobial Resistance and Infection Control2047-29942019-04-01811910.1186/s13756-019-0520-8A retrospective analysis of Pseudomonas aeruginosa bloodstream infections: prevalence, risk factors, and outcome in carbapenem-susceptible and -non-susceptible infectionsQingyi Shi0Chen Huang1Tingting Xiao2Zhenzhu Wu3Yonghong Xiao4State Key Laboratory for Diagnosis and Treatment of Infectious Disease, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang UniversityState Key Laboratory for Diagnosis and Treatment of Infectious Disease, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang UniversityState Key Laboratory for Diagnosis and Treatment of Infectious Disease, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang UniversityState Key Laboratory for Diagnosis and Treatment of Infectious Disease, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang UniversityState Key Laboratory for Diagnosis and Treatment of Infectious Disease, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang UniversityAbstract Background Pseudomonas aeruginosa (PA) is a leading cause of nosocomial infections, and carbapenem non-susceptible strains are a major threat to patient safety. Methods A single center, retrospective comparative analysis of carbapenem-non-susceptible PA (CnSPA) and carbapenem-susceptible PA (CSPA) bloodstream infections (BSIs) was conducted between January 1, 2007, and December 31, 2016. Prevalence and risk factors associated with CnSPA BSIs were examined. Results The study enrolled 340 patients with PA BSIs; 30.0% (N = 101) of patients had CnSPA. High APACHE II scores (≥15), central venous catheterization, and delayed application of appropriate definitive therapy were independently associated with higher risk of mortality in PA BSIs. Multivariate analysis revealed that respiratory disease and exposure to carbapenems within the previous 90 days to onset of BSI were independent risk factors for acquisition of CnSPA BSIs. Overall all-cause 30-day mortality associated with PA BSIs was 26.8% (91/340). In addition, mortality was higher in patients with CnSPA than in those with CSPA (37.6% vs. 22.2%, respectively; P = 0.003). Corticosteroid therapy and delayed receipt of effective definitive therapy were independent risk factors for death from CnSPA BSIs. Conclusion Increased incidence of CnSPA BSIs was observed during the study period, with higher mortality seen in patients with these infections. Respiratory disease and exposure to carbapenems were independent risk factors for development of CnSPA BSIs. Appropriate definitive therapy reduced mortality rates. BLBLIs were as effective as carbapenems as a treatment for PA BSIs.http://link.springer.com/article/10.1186/s13756-019-0520-8Carbapenem-non-susceptible Pseudomonas aeruginosaBloodstream infectionClinical characteristicRisk factorPrognosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Qingyi Shi Chen Huang Tingting Xiao Zhenzhu Wu Yonghong Xiao |
spellingShingle |
Qingyi Shi Chen Huang Tingting Xiao Zhenzhu Wu Yonghong Xiao A retrospective analysis of Pseudomonas aeruginosa bloodstream infections: prevalence, risk factors, and outcome in carbapenem-susceptible and -non-susceptible infections Antimicrobial Resistance and Infection Control Carbapenem-non-susceptible Pseudomonas aeruginosa Bloodstream infection Clinical characteristic Risk factor Prognosis |
author_facet |
Qingyi Shi Chen Huang Tingting Xiao Zhenzhu Wu Yonghong Xiao |
author_sort |
Qingyi Shi |
title |
A retrospective analysis of Pseudomonas aeruginosa bloodstream infections: prevalence, risk factors, and outcome in carbapenem-susceptible and -non-susceptible infections |
title_short |
A retrospective analysis of Pseudomonas aeruginosa bloodstream infections: prevalence, risk factors, and outcome in carbapenem-susceptible and -non-susceptible infections |
title_full |
A retrospective analysis of Pseudomonas aeruginosa bloodstream infections: prevalence, risk factors, and outcome in carbapenem-susceptible and -non-susceptible infections |
title_fullStr |
A retrospective analysis of Pseudomonas aeruginosa bloodstream infections: prevalence, risk factors, and outcome in carbapenem-susceptible and -non-susceptible infections |
title_full_unstemmed |
A retrospective analysis of Pseudomonas aeruginosa bloodstream infections: prevalence, risk factors, and outcome in carbapenem-susceptible and -non-susceptible infections |
title_sort |
retrospective analysis of pseudomonas aeruginosa bloodstream infections: prevalence, risk factors, and outcome in carbapenem-susceptible and -non-susceptible infections |
publisher |
BMC |
series |
Antimicrobial Resistance and Infection Control |
issn |
2047-2994 |
publishDate |
2019-04-01 |
description |
Abstract Background Pseudomonas aeruginosa (PA) is a leading cause of nosocomial infections, and carbapenem non-susceptible strains are a major threat to patient safety. Methods A single center, retrospective comparative analysis of carbapenem-non-susceptible PA (CnSPA) and carbapenem-susceptible PA (CSPA) bloodstream infections (BSIs) was conducted between January 1, 2007, and December 31, 2016. Prevalence and risk factors associated with CnSPA BSIs were examined. Results The study enrolled 340 patients with PA BSIs; 30.0% (N = 101) of patients had CnSPA. High APACHE II scores (≥15), central venous catheterization, and delayed application of appropriate definitive therapy were independently associated with higher risk of mortality in PA BSIs. Multivariate analysis revealed that respiratory disease and exposure to carbapenems within the previous 90 days to onset of BSI were independent risk factors for acquisition of CnSPA BSIs. Overall all-cause 30-day mortality associated with PA BSIs was 26.8% (91/340). In addition, mortality was higher in patients with CnSPA than in those with CSPA (37.6% vs. 22.2%, respectively; P = 0.003). Corticosteroid therapy and delayed receipt of effective definitive therapy were independent risk factors for death from CnSPA BSIs. Conclusion Increased incidence of CnSPA BSIs was observed during the study period, with higher mortality seen in patients with these infections. Respiratory disease and exposure to carbapenems were independent risk factors for development of CnSPA BSIs. Appropriate definitive therapy reduced mortality rates. BLBLIs were as effective as carbapenems as a treatment for PA BSIs. |
topic |
Carbapenem-non-susceptible Pseudomonas aeruginosa Bloodstream infection Clinical characteristic Risk factor Prognosis |
url |
http://link.springer.com/article/10.1186/s13756-019-0520-8 |
work_keys_str_mv |
AT qingyishi aretrospectiveanalysisofpseudomonasaeruginosabloodstreaminfectionsprevalenceriskfactorsandoutcomeincarbapenemsusceptibleandnonsusceptibleinfections AT chenhuang aretrospectiveanalysisofpseudomonasaeruginosabloodstreaminfectionsprevalenceriskfactorsandoutcomeincarbapenemsusceptibleandnonsusceptibleinfections AT tingtingxiao aretrospectiveanalysisofpseudomonasaeruginosabloodstreaminfectionsprevalenceriskfactorsandoutcomeincarbapenemsusceptibleandnonsusceptibleinfections AT zhenzhuwu aretrospectiveanalysisofpseudomonasaeruginosabloodstreaminfectionsprevalenceriskfactorsandoutcomeincarbapenemsusceptibleandnonsusceptibleinfections AT yonghongxiao aretrospectiveanalysisofpseudomonasaeruginosabloodstreaminfectionsprevalenceriskfactorsandoutcomeincarbapenemsusceptibleandnonsusceptibleinfections AT qingyishi retrospectiveanalysisofpseudomonasaeruginosabloodstreaminfectionsprevalenceriskfactorsandoutcomeincarbapenemsusceptibleandnonsusceptibleinfections AT chenhuang retrospectiveanalysisofpseudomonasaeruginosabloodstreaminfectionsprevalenceriskfactorsandoutcomeincarbapenemsusceptibleandnonsusceptibleinfections AT tingtingxiao retrospectiveanalysisofpseudomonasaeruginosabloodstreaminfectionsprevalenceriskfactorsandoutcomeincarbapenemsusceptibleandnonsusceptibleinfections AT zhenzhuwu retrospectiveanalysisofpseudomonasaeruginosabloodstreaminfectionsprevalenceriskfactorsandoutcomeincarbapenemsusceptibleandnonsusceptibleinfections AT yonghongxiao retrospectiveanalysisofpseudomonasaeruginosabloodstreaminfectionsprevalenceriskfactorsandoutcomeincarbapenemsusceptibleandnonsusceptibleinfections |
_version_ |
1724957119088689152 |