Document Detail


Morbidity associated with Pseudomonas aeruginosa bloodstream infections.
MedLine Citation:
PMID:  19345039     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We sought to quantify patient morbidity throughout Pseudomonas aeruginosa bloodstream infection (PABSI) as a function of patient covariates. Individuals with PABSI were included in a retrospective, observational, cohort study. Morbidity was quantified by serial Sequential Organ Failure Assessment (SOFA) scores. Impact of active antimicrobial treatment was assessed as a function of changes in SOFA scores as the dependent variable. A total of 95 patients with PABSI were analyzed. Relative to baseline SOFA scores (day -2), scores after PABSI were increased by 37% on day 0 and 22% on day +2 but returned to baseline on day +7. Overall mortality was 37%, and mean length of hospital stay (postculture) was 16 days. Most patients were appropriately treated, with n = 83 (87%) receiving an active agent and n = 61 (64%) receiving >1 agent. As a result, an effect of therapy on morbidity was not observed. Advanced age and elevated baseline SOFA scores predicted increased in-hospital mortality (P = 0.01 and P < 0.001, respectively) and morbidity at day +2 (P < 0.05 and P < 0.05, respectively) and day +7 (P < 0.05 and P < 0.001, respectively). Neutropenia was also associated with increased morbidity at day +2 (P < 0.05). In treated PABSI, morbidity is highest the day of the diagnostic blood cultures and slowly returns to baseline over the subsequent 7 days. Age and baseline severity of illness are the strongest predictors of morbidity and mortality. Because neither of these factors are modifiable, efforts to minimize the negative impact of PABSI should focus on appropriate prevention and infection control efforts.
Authors:
Marc H Scheetz; Michael Hoffman; Maureen K Bolon; Grant Schulert; Wendy Estrellado; Ioannis G Baraboutis; Padman Sriram; Minh Dinh; Linda K Owens; Alan R Hauser
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2009-04-02
Journal Detail:
Title:  Diagnostic microbiology and infectious disease     Volume:  64     ISSN:  1879-0070     ISO Abbreviation:  Diagn. Microbiol. Infect. Dis.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-08     Completed Date:  2009-07-27     Revised Date:  2014-09-10    
Medline Journal Info:
Nlm Unique ID:  8305899     Medline TA:  Diagn Microbiol Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  311-9     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Anti-Bacterial Agents / therapeutic use
Bacteremia / microbiology*,  mortality*
Cohort Studies
Female
Humans
Length of Stay
Male
Middle Aged
Neutropenia / complications
Pseudomonas Infections / mortality*
Pseudomonas aeruginosa / isolation & purification*
Retrospective Studies
Risk Factors
Severity of Illness Index
Grant Support
ID/Acronym/Agency:
AI053674/AI/NIAID NIH HHS; AI065615/AI/NIAID NIH HHS; K02 AI065615/AI/NIAID NIH HHS; K02 AI065615-01/AI/NIAID NIH HHS; R01 AI053674/AI/NIAID NIH HHS; R01 AI053674-01A1/AI/NIAID NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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