Clinical characteristics and risk factors for mortality in cefepime-resistant Pseudomonas aeruginosa bacteremia

Bacterial keratitis is a devastating condition that can rapidly progress to serious complications if not treated promptly. Certain causative microorganisms such as Staphylococcus aureus and Pseudomonas aeruginosa are notorious for their resistance to antibiotics. Resistant bacterial keratitis results in poorer outcomes such as scarring and the need for surgical intervention. Thorough understanding of the causative pathogen and its virulence factors is vital for the discovery of novel treatments to avoid further antibiotic resistance. While much has been previously reported on P. aeruginosa, S. aureus has been less extensively studied. This review aims to give a brief overview of S. aureus epidemiology, pathophysiology and clinical characteristics as well as summarise the current evidence for potential novel therapies.

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Clinical Characteristics and Risk Factors for Mortality in Patients with Bacteremia Caused by Pseudomonas aeruginosa

Internal Medicine ◽

10.2169/internalmedicine.51.5698 ◽

2012 ◽

Vol 51 (1) ◽

pp. 59-64 ◽

Cited By ~ 12

Author(s):

Tetsuya Horino ◽

Akio Chiba ◽

Shinji Kawano ◽

Tetsuro Kato ◽

Fumiya Sato ◽

...

Keyword(s):

Risk Factors ◽

Pseudomonas Aeruginosa ◽

Clinical Characteristics

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Clinical characteristics and risk factors for mortality in children with Pseudomonas aeruginosa bacteraemia: A retrospective review at a paediatric tertiary centre

Journal of Paediatrics and Child Health ◽

10.1111/jpc.15634 ◽

2021 ◽

Author(s):

Kenji Kishimoto ◽

Masashi Kasai ◽

Noriko Kawamura ◽

Shogo Otake ◽

Daiichiro Hasegawa ◽

...

Keyword(s):

Risk Factors ◽

Pseudomonas Aeruginosa ◽

Retrospective Review ◽

Clinical Characteristics ◽

Tertiary Centre

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Different Clinical Characteristics and Impacts of Carbapenem-Resistance on Outcomes Between Acinetobacter Baumannii and Pseudomonas Aeruginosa Bacteraemia: A Multicentre Prospective Observational Study

10.21203/rs.3.rs-812345/v1 ◽

2021 ◽

Author(s):

Chan Mi Lee ◽

Young-Jun Kim ◽

Sook-In Jung ◽

Seong Eun Kim ◽

Wan Beom Park ◽

...

Keyword(s):

Risk Factors ◽

Pseudomonas Aeruginosa ◽

Risk Factor ◽

Treatment Failure ◽

Acinetobacter Baumannii ◽

Clinical Outcomes ◽

Clinical Characteristics ◽

Significant Risk ◽

Carbapenem Resistance ◽

Independent Risk Factors

Abstract Background: Carbapenem-resistance (CR) causes poor clinical outcomes and has limited treatment options. We aim to evaluate the differences in clinical characteristics and impact of carbapenem-resistance on outcomes between Acinetobacter baumannii (ABA) and Pseudomonas aeruginosa (PAE) bacteraemia. Methods: We prospectively identified all patients with ABA and PAE bacteraemia in 10 hospitals over a 1-year period and collected their detailed clinical information. Treatment failure was defined as all-cause 30-day mortality, persistent bacteraemia, or recurrence within 30 days.Results: We included 304 ABA and 241 PAE bacteraemia cases. CR was detected in 216 ABA (71%) and 55 PAE (23%). Treatment failure was significantly higher in CR-ABA than in CR-PAE (60.6% vs. 34.5%, P = 0.001). Multivariate analyses were stratified by patient data according to CR and the appropriateness of empirical therapy. For ABA patients, severe sepsis or septic shock and high Pitt bacteraemia score were independent risk factors for treatment failure in the inappropriate empirical antibiotics group. Pneumonia was a significant risk factor in the appropriate group. For PAE patients, hospital-acquired infection and high Pitt bacteraemia score were independent risk factors for treatment failure in both groups. CR was an independent risk factor in ABA for treatment failure in both the inappropriate (adjusted odds ratio [aOR]: 6.17, 95% confidence interval [CI]: 1.13-33.75, P = 0.036) and appropriate empirical treatment groups (aOR: 4.15, 95% CI: 1.16-14.84, P = 0.029), but not for patients with PAE bacteraemia. Conclusions: We demonstrated significant differences in the clinical characteristics and impact of CR on the clinical outcomes between ABA and PAE bacteraemia. Our findings suggest that different approaches may be needed to treat ABA and PAE bacteraemia.

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Risk Factors and Outcomes of Antibiotic-resistant Pseudomonas aeruginosa Bloodstream Infection in Adult Patients With Acute Leukemia

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1522 ◽

2020 ◽

Vol 71 (Supplement_4) ◽

pp. S386-S393

Author(s):

Yuanqi Zhao ◽

Qingsong Lin ◽

Li Liu ◽

Runzhi Ma ◽

Juan Chen ◽

...

Keyword(s):

Risk Factors ◽

Pseudomonas Aeruginosa ◽

Antibiotic Resistance ◽

Acute Leukemia ◽

Bloodstream Infection ◽

Clinical Characteristics ◽

Antibiotic Use ◽

Limited Information ◽

Antibiotic Resistant ◽

Resistant Strains

Abstract Background Pseudomonas aeruginosa (PA) bloodstream infection (BSI) is a common complication in patients with acute leukemia (AL), and the prevalence of antibiotic-resistant strains poses a serious problem. However, there is limited information regarding antibiotic resistance, clinical characteristics, and outcomes of PA BSI in AL patients. This study explored characteristics associated with the clinical outcomes of AL patients with PA BSI and analyzed factors associated with BSI caused by multidrug-resistant (MDR) or carbapenem-resistant strains. Methods This single-center retrospective study enrolled hospitalized AL patients who developed PA BSI during January 2014–December 2019. The Kaplan-Meier method was used to plot survival curves. Multivariate logistic regression analyses were also performed. Results Of 293 eligible patients with PA BSI, 55 (18.8%) received inappropriate empirical antibiotic therapy within 48 hours of BSI onset, whereas up to 65.8% MDR-PA BSI patients received inappropriate empirical treatment. The 30-day mortality rate was 8.5% for all patients. However, the 30-day mortality rates were 28.9% and 5.5% in MDR-PA BSI and non–MDR-PA BSI patients, respectively (P < .001). On multivariate analysis, previous use of quinolones (odds ratio [OR], 5.851 [95% confidence interval {CI}, 2.638–12.975]) and piperacillin/tazobactam (OR, 2.837 [95% CI, 1.151–6.994]) were independently associated with MDR-PA BSI; and MDR-PA BSI (OR, 7.196 [95% CI, 2.773–18.668]), perianal infection (OR, 4.079 [95% CI, 1.401–11.879]), pulmonary infection (OR, 3.028 [95% CI, 1.231–7.446]), and age ≥55 years (OR, 2.871 [95% CI, 1.057–7.799]) were independent risk factors for 30-day mortality. Conclusions MDR increases mortality risk in PA BSI patients, and previous antibiotic exposure is important in MDR-PA BSI development. Rational antibiotic use based on local antimicrobial susceptibility and clinical characteristics can help reduce antibiotic resistance and mortality.

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