Risk factors for 30-Day mortality and the role of empirical therapy in Pseudomonas aeruginosa bloodstream infections.
Purpose: P. aeruginosa bloodstream infections (BSIs) represent one of the most common conditions associated with increased healthcare costs, prolonged hospitalization and high attributable mortality. The primary objective of our study was to investigate all-cause 30-day mortality associated with P....
| Published in: | Infection Vol. 53; no. 5; pp. 2243 - 2257 |
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| Main Authors: | , , , , , , , , , , , , , , , , , , , |
| Format: | letter research tables/charts Journal Article |
| Published: |
Springer Nature
Oct2025
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=188243106&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 188243106 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03008126 NXO jtl: Infection issn: 03008126 maglogo: N pubinfo: dt: Oct2025 vid: 53 iid: 5 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 188243106 186948936 188243106 188243106 10.1007/s15010-025-02603-y 188243106 ppf: 2243 ppct: 14 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Risk factors for 30-Day mortality and the role of empirical therapy in Pseudomonas aeruginosa bloodstream infections. aug: au: Geremia, Nicholas Giovagnorio, Federico Vena, Antonio Corcione, Silvia Giannella, Maddalena Pinna, Simone Mornese Giovannenze, Francesca Pascale, Renato Bavaro, Davide Fiore Brusasco, Beatrice Scaglione, Vincenzo Mikulska, Malgorzata Vassia, Veronica Merli, Marco Giacobbe, Daniele Roberto Marino, Andrea Accurso, Giuseppe Pagani, Gabriele Faliero, Domenico Fumarola, Benedetta affil: https://ror.org/040d6j646 Unit of Infectious Diseases, Department of Clinical Medicine, Ospedale "Dell'Angelo", Venice, Italy sug: subj: Mortality Risk Factors Pseudomonas Infections Drug Therapy Bacteremia Drug Therapy Pseudomonas Infections Mortality Bacteremia Mortality Cause of Death Evaluation Risk Assessment Antibiotics, Combined Therapeutic Use Human Male Female Middle Age Aged Multicenter Studies Retrospective Design Record Review Hospitals, Public Italy Descriptive Statistics Multiple Logistic Regression Age Factors Sepsis Shock, Septic Pseudomonas Infections Prognosis Bacteremia Prognosis In Vitro Studies Microbial Culture and Sensitivity Tests Comparative Studies Fisher's Exact Test Mann-Whitney U Test Kruskal-Wallis Test Cox Proportional Hazards Model Multiple Regression Univariate Statistics Kaplan-Meier Estimator Log-Rank Test Data Analysis Software Confidence Intervals Odds Ratio Association (Research) Inpatients Urinary Tract Infections Pneumonia, Ventilator-Associated Healthcare-Associated Pneumonia Intraabdominal Infections Funding Source Blood Culture Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Purpose: P. aeruginosa bloodstream infections (BSIs) represent one of the most common conditions associated with increased healthcare costs, prolonged hospitalization and high attributable mortality. The primary objective of our study was to investigate all-cause 30-day mortality associated with P. aeruginosa BSIs. Methods: We conducted a multicenter, retrospective cohort study in 14 Italian hospitals, including all consecutive patients with P. aeruginosa BSIs from January 2021 to December 2022. We included all patients who were ≥ 18 years old with P. aeruginosa BSIs treated for at least 48 h with an anti-Pseudomonal antibiotic regimen that was sensitive in vitro. Results: Six hundred and thirty-nine P. aeruginosa BSIs were collected from participating centers. After applying the exclusion criteria, 511 BSIs remain. The median age was 68.0 (IQR 57.0–77.0). Three hundred and forty (66.5%) patients were male. One hundred eight (21.1%) patients experienced in-hospital 30-day mortality. Most BSIs were caused by susceptible strains of P. aeruginosa (474 isolates, 92.8%). At the multivariate logistic regression analysis, older age [1.03 (1.01–1.05), p = 0.003], presence of sepsis [OR 2.75 (1.43–5.27), p = 0.002], presence of septic shock [6.53 (3.33–12.80), p < 0.001] and high-risk infections [OR 2.74 (1.36–5.49), p = 0.005] were associated with the worst outcome. The combination of empirical therapy [OR 0.39 (0.16–0.96), p = 0.04] was the only variable associated with improved survival. Conclusion: Appropriate empirical therapy with two in vitro active molecules was beneficial in terms of all-cause 30-day mortality, especially in patients with severe clinical presentations, such as septic shock and high-risk infections. pubtype: Academic Journal doctype: letter research tables/charts Journal Article ougenre: Unknown language: English refInfo: holdings: @attributes: islocal: N |
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