Details

Autor(en) / Beteiligte

• Babich, Tanya
• Naucler, Pontus
• Valik, John Karlsson
• Giske, Christian G.
• Benito, Natividad
• Cardona, Ruben
• Rivera, Alba
• Pulcini, Celine
• Fattah, Manal Abdel
• Haquin, Justine
• MacGowan, Alasdair
• Grier, Sally
• Chazan, Bibiana
• Yanovskay, Anna
• Ami, Ronen Ben
• Landes, Michal
• Nesher, Lior
• Zaidman-Shimshovitz, Adi
• McCarthy, Kate
• Paterson, David L.
• Tacconelli, Evelina
• Buhl, Michael
• Maurer, Susanna
• Rodriguez-Bano, Jesus
• Morales, Isabel
• Oliver, Antonio
• de Gopegui, Enrique Ruiz
• Cano, Angela
• Machuca, Isabel
• Gozalo-Marguello, Monica
• Martinez-Martinez, Luis
• Gonzalez-Barbera, Eva M.
• Alfaro, Iris Gomez
• Salavert, Miguel
• Beovic, Bojana
• Saje, Andreja
• Mueller-Premru, Manica
• Pagani, Leonardo
• Vitrat, Virginie
• Kofteridis, Diamantis
• Zacharioudaki, Maria
• Maraki, Sofia
• Weissman, Yulia
• Paul, Mical
• Dickstein, Yaakov
• Leibovici, Leonard
• Yahav, Dafna

Titel

Risk factors for mortality among patients with Pseudomonas aeruginosa bacteraemia: a retrospective multicentre study

Ist Teil von

• International journal of antimicrobial agents, 2020-02, Vol.55 (2), p.105847-105847, Article 105847

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2020

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• •30-day all-cause mortality in Pseudomonas aeruginosa bacteraemia was high (26.5%).•Most risk factors for mortality are non-modifiable.•These include age, sex, baseline medical condition and functional capacity.•Resistance, non-urinary source and severity score are also risk factors.•Inappropriate empirical therapy is not significantly associated with mortality. This study aimed to evaluate risk factors for 30-day mortality among hospitalised patients with Pseudomonas aeruginosa bacteraemia, a highly fatal condition. A retrospective study was conducted between 1 January 2009 and 31 October 2015 in 25 centres (9 countries) including 2396 patients. Univariable and multivariable analyses of risk factors were conducted for the entire cohort and for patients surviving ≥48 h. A propensity score for predictors of appropriate empirical therapy was introduced into the analysis. Of the 2396 patients, 636 (26.5%) died within 30 days. Significant predictors (odds ratio and 95% confidence interval) of mortality in the multivariable analysis included patient-related factors: age (1.02, 1.01–1.03); female sex (1.34, 1.03–1.77); bedridden functional capacity (1.99, 1.24–3.21); recent hospitalisation (1.43, 1.07–1.92); concomitant corticosteroids (1.33, 1.02–1.73); and Charlson comorbidity index (1.05, 1.01–1.93). Infection-related factors were multidrug-resistant Pseudomonas (1.52, 1.15–2.1), non-urinary source (2.44, 1.54–3.85) and Sequential Organ Failure Assessment (SOFA) score (1.27, 1.18–1.36). Inappropriate empirical therapy was not associated with increased mortality (0.81, 0.49–1.33). Among 2135 patients surviving ≥48 h, hospital-acquired infection (1.59, 1.21–2.09), baseline endotracheal tube (1.63, 1.13–2.36) and ICU admission (1.53, 1.02–2.28) were additional risk factors. Risk factors for mortality among patients with P. aeruginosa were mostly irreversible. Early appropriate empirical therapy was not associated with reduced mortality. Further research should be conducted to explore subgroups that may not benefit from broad-spectrum antipseudomonal empirical therapy. Efforts should focus on prevention of infection, mainly hospital-acquired infection and multidrug-resistant pseudomonal infection.