Clinical analysis of 56 cases of bloodstream infections due to Pseudomonas aeruginosa

Objective To investigate the risk factors and outcomes of bloodstream infections due to Pseudomonas aeruginosa. Methods A 1:1 matched case-control study was conducted in Fujian Provincial Hospital. A total of 56 patients with bloodstream infection due to P. aeruginosa were compared with 56 control patients with bloodstream infections due to Klebsiella pneumoniae or Escherichia coli between January 2006 and September 2015, according to the matching criteria based on underlying disease, sex, age, hospital stay before the index bloodstream infection, and hospital department. Univariate and multivariate conditional logistic regression analysis were introduced to reveal the risk and prognostic factors. Results Multivariate conditional logistic regression analysis showed that prior use of more than two types of antipseudomonal antibiotics (OR: 4.92, 95% CI: 1.31-18.44) and anti-MRSA drugs (OR: 9.09, 95% CI: 1.05-78.99) were the independent predisposing factors for detection of P. aeruginosa bloodstream infection. The 30-day mortality rate of the case patients (30.4%) was significantly higher than that of the control group (14.3%) (χ² = 4.171, P = 0.041). The Acute Physiology and Chronic Health Evaluation (APACHE II) score (OR: 1.23, 95% CI: 1.08-1.40) and inappropriate empiric antimicrobial therapy (OR: 6.55, 95% CI: 1.44-29.72) were the independent risk factor for mortality in P. aeruginosa bloodstream infections. Conclusions Disease severity is a critical factor for mortality in our patients with P. aeruginosa bloodstream infection. Rational use of antibiotics and more appropriate antimicrobial therapy might improve the outcome of patients with P. aeruginosa bloodstream infections.