Pseudomonas aeruginosa bacteremia upon hospital admission: Risk factors for mortality and influence of inadequate empirical antimicrobial therapy

Vered Schechner*, Tamar Gottesman, Orna Schwartz, Maya Korem, Yasmin Maor, Galia Rahav, Rivka Karplus, Tsipora Lazarovitch, Eyal Braun, Renato Finkelstein, Tamar Lachish, Yonit Wiener-Well, Danny Alon, Michal Chowers, Rita Bardenstein, Oren Zimhony, Alona Paz, Israel Potasman, Michael Giladi, Mitchell J. SchwaberShiri Klarfeld-Lidji, Meirav Hochman, Dror Marchaim, Yehuda Carmeli

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

36 Scopus citations

Abstract

Pseudomonas aeruginosa is an uncommon cause of bacteremia upon hospital admission (UHA) and the chosen empirical antimicrobial therapy may not cover it appropriately. In a multicenter prospective study conducted in Israel, we evaluated risk factors for in-hospital mortality in patients with P. aeruginosa bacteremia UHA and determined the influence of delay in adequate empirical antimicrobial therapy on patients' outcome. Seventy-six adult patients with P. aeruginosa bacteremia within 72 h of hospital admission were included. Demographic, clinical, and treatment data were collected. Microbiological adequacy of empirical therapy was determined. Severe sepsis or septic shock at admission (OR, 21.9; P < 0.001), respiratory or unknown sources of bacteremia (OR, 11.5; P = 0.003), recent hospitalization (OR, 6.2; P = 0.032), and poor functional status (OR, 5.8; P = 0.029) were identified as independent predictors of mortality. Inadequate empirical antimicrobial therapy was marginally associated with increased mortality only among patients who presented with severe sepsis or septic shock (P = 0.051).

Original languageEnglish
Pages (from-to)38-45
Number of pages8
JournalDiagnostic Microbiology and Infectious Disease
Volume71
Issue number1
DOIs
StatePublished - Sep 2011
Externally publishedYes

Funding

FundersFunder number
MSD Israel

    Keywords

    • Antimicrobial therapy
    • Bacteremia
    • Empirical therapy
    • Mortality
    • Pseudomonas aeruginosa
    • Risk factors

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