Pseudomonas aeruginosa Community-Onset Bloodstream Infections: Characterization, Diagnostic Predictors, and Predictive Score Development-Results from the PRO-BAC Cohort

被引：3

作者：

Martinez Perez-Crespo, Pedro Maria ^{[1
,2
,3
]}

Rojas, Alvaro ^{[4
]}

Felipe Lanz-Garcia, Joaquin ^{[1
,2
]}

Retamar-Gentil, Pilar ^{[1
,2
]}

Maria Reguera-Iglesias, Jose ^{[5
]}

Lima-Rodriguez, Olalla ^{[6
]}

del Arco Jimenez, Alfonso ^{[7
]}

Fernandez Suarez, Jonathan ^{[8
]}

Jover-Saenz, Alfredo ^{[9
]}

Goikoetxea Aguirre, Josune ^{[10
]}

Leon Jimenez, Eva ^{[3
]}

Luisa Canton-Bulnes, Maria ^{[11
]}

Ortega Lafont, Pilar ^{[12
]}

Arminanzas Castillo, Carlos ^{[13
]}

Blanco, Juan Sevilla ^{[14
]}

Cuquet Pedragosa, Jordi ^{[15
]}

Boix-Palop, Lucia ^{[16
]}

Becerril Carral, Berta ^{[17
]}

Bahamonde-Carrasco, Alberto ^{[18
]}

Marrodan Ciordia, Teresa ^{[19
]}

Natera Kindelan, Clara ^{[20
]}

Reche Molina, Isabel Maria ^{[21
]}

Herrero Rodriguez, Carmen ^{[22
]}

Perez Camacho, Ines ^{[23
]}

Vinuesa Garcia, David ^{[24
]}

Galan-Sanchez, Fatima ^{[25
]}

Smithson Amat, Alejandro ^{[26
]}

Merino de Lucas, Esperanza ^{[27
]}

Sanchez-Porto, Antonio ^{[28
]}

Guzman Garcia, Marcos ^{[29
]}

Lopez-Hernandez, Inmaculada ^{[1
,2
]}

Rodriguez-Bano, Jesus ^{[1
,2
]}

Eduardo Lopez-Cortes, Luis ^{[1
,2
]}

机构：

[1] Univ Seville, Biomed Inst Sevilla, Hosp Univ Virgen Macarena, Infect Dis & Microbiol Unit, Seville 41009, Spain

[2] Univ Seville, Biomed Inst Sevilla, Dept Med, Seville 41009, Spain

[3] Hosp Univ Nuestra Senora de Valme, Unidad Enfermedades Infecciosas & Microbiol, Seville 41014, Spain

[4] Pontificia Univ Catolica Chile, Fac Med, Dept Enfermedades Infecciosas Adulto, Santiago 8331150, Chile

[5] Hosp Reg Univ Malaga, Serv Enfermedades Infecciosas, IBIMA Malaga, Malaga 29010, Spain

[6] Hosp Alvaro Cunqueiro, Unidad Enfermedades Infecciosas, Serv Med Interna, Vigo 36312, Spain

[7] Hosp Costa del Sol, Grp Enfermedades Infecciosas, Serv Med Interna, Marbella 29603, Spain

[8] Hosp Univ Cent Asturias, Unidad Microbiol, Inst Invest Sanitaria Principado Asturias ISPA, Oviedo 33011, Spain

[9] Hosp Arnau Vilanova, Unidad Func Infecc Nosocomiales, Lerida 25198, Spain

[10] Hosp Univ Cruces, Unidad Enfermedades Infecciosas, Bizkaia 48903, Spain

[11] Hosp Univ Virgen Macarena, Unidad Cuidados Intens, Seville 41009, Spain

[12] Hosp Univ Burgos, Unidad Gest Clin Enfermedades Infecciosas, Burgos 09006, Spain

[13] Univ Cantabria, Hosp Univ Marques de Valdecilla, IDIVAL, Unidad Enfermedades Infecciosas, Santander 39008, Spain

[14] Hosp Univ Jerez de la Frontera, Unidad Gest Clin Enfermedades Infecciosas & Micro, Jerez de la Frontera 11407, Spain

[15] Hosp Univ Granollers, Dept Med Interna, Granollers 08402, Spain

[16] Hosp Univ Mutua Terrassa, Unidad Enfermedades Infecciosas, Barcelona 08221, Spain

[17] Area Sanitaria Campo Gibraltar, Unidad Clin Gest Enfermedades Infecciosas & Micro, Cadiz 11207, Spain

[18] Hosp El Bierzo, Dept Med Interna, Ponferrada 24404, Spain

[19] Complejo Asistencial Univ Leon CAULE, Dept Microbiol Clin, Leon 24071, Spain

[20] Hosp Univ Reina Sofia, Unidad Clin Enfermedades Infecciosas, Cordoba 14004, Spain

[21] Hosp Univ Torrecardenas, Unidad Enfermedades Infecciosas, Almeria 04009, Spain

[22] Complejo Hosp Jaen, Unidad Gest Clin Enfermedades Infecciosas & Micro, Jaen 23007, Spain

[23] Hosp Gen Poniente, Unidad Med Trop, El Ejido 04700, Spain

[24] Hosp Univ Clin San Cecilio, Unidad Gest Clin Enfermedades Infecciosas, Granada 18016, Spain

[25] Hosp Univ Puerta del Mar, Unidad Gest Clin Microbiol, Cadiz 11009, Spain

[26] Fundacio Hosp Esperit St, Unidad Med Interna, Santa Coloma De Gramenet 08923, Spain

[27] Hosp Univ Gen Alicante, Unidad Enfermedades Infecciosas, Alicante 03010, Spain

[28] Hosp Linea de La Concepcion, Unidad Enfermedades Infecciosas & Microbiol, La Linea De Concepcion 11300, Spain

[29] Hosp San Juan de la Cruz, Serv Med Interna, Ubeda 23400, Spain

来源：

ANTIBIOTICS-BASEL | 2022年 / 11卷 / 06期

关键词：

Pseudomonas aeruginosa; bacteraemia; bloodstream infection; community-onset; epidemiology; BACTEREMIA; EPIDEMIOLOGY; DEFINITIONS; MORTALITY; THERAPY; SEPSIS;

D O I：

10.3390/antibiotics11060707

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Community-onset bloodstream infections (CO-BSI) caused by gram-negative bacilli are common and associated with significant mortality; those caused by Pseudomonas aeruginosa are associated with worse prognosis and higher rates of inadequateempirical antibiotic treatment. The aims of this study were to describe the characteristics of patients with CO-BSI caused by P. aeruginosa, to identify predictors, and to develop a predictive score for P. aeruginosa CO-BSI. Materials/methods: PROBAC is a prospective cohort including patients >14 years with BSI from 26 Spanish hospitals between October 2016 and May 2017. Patients with monomicrobial P. aeruginosa CO-BSI and monomicrobial Enterobacterales CO-BSI were included. Variables of interest were collected. Independent predictors of Pseudomonas aeruginosa CO-BSI were identified by logistic regression and a prediction score was developed. Results: A total of 78patients with P. aeruginosa CO-BSI and 2572 with Enterobacterales CO-BSI were included. Patients with P. aeruginosa had a median age of 70 years (IQR 60-79), 68.8% were male, median Charlson score was 5 (IQR 3-7), and 30-daymortality was 18.5%. Multivariate analysis identified the following predictors of CO-BSI-PA [adjusted OR (95% CI)]: male gender [1.89 (1.14-3.12)], haematological malignancy [2.45 (1.20-4.99)], obstructive uropathy [2.86 (1.13-3.02)], source of infection other than urinary tract, biliary tract or intra-abdominal [6.69 (4.10-10.92)] and healthcare-associated BSI [1.85 (1.13-3.02)]. Anindex predictive of CO-BSI-PA was developed; scores >= 3.5 showed a negative predictive value of 89% and an area under the receiver operator curve (ROC) of 0.66. Conclusions: We did not find a good predictive score of P. aeruginosa CO-BSI due to its relatively low incidence in the overall population. Our model includes variables that are easy to collect in real clinical practice and could be useful to detect patients with very low risk of P. aeruginosa CO-BSI.

引用

页数：11

共 2 条

[1] Revisiting the epidemiology of bloodstream infections and healthcare-associated episodes: results from a multicentre prospective cohort in Spain (PRO-BAC Study)
Martinez Perez-Crespo, Pedro Maria
Felipe Lanz-Garcia, Joaquin
Bravo-Ferrer, Jose
Luisa Canton-Bulnes, Maria
Sousa Dominguez, Adrian
Goikoetxea Aguirre, Josune
Maria Reguera-Iglesias, Jose
Leon Jimenez, Eva
Arminanzas Castillo, Carlos
Mantecon Vallejo, Maria Angeles
Marrodan Ciordia, Teresa
Fernandez Suarez, Jonathan
Boix-Palop, Lucia
Cuquet Pedragosa, Jordi
Jover Saenz, Alfredo
Sevilla Blanco, Juan
Galan-Sanchez, Fatima
Natera Kindelan, Clara
del Arco Jimenez, Alfonso
Bahamonde-Carrasco, Alberto
Smithson Amat, Alejandro
Vinuesa Garcia, David
Herrero Rodriguez, Carmen
Reche Molina, Isabel Maria
Perez Camacho, Ines
Sanchez-Porto, Antonio
Guzman Garcia, Marcos
Becerril Carral, Berta
Merino de Lucas, Esperanza
Lopez-Hernandez, Inmaculada
Rodriguez-Bano, Jesus
Eduardo Lopez-Cortes, Luis
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS, 2021, 58 (01)
[2] Rates, predictors and mortality of community-onset bloodstream infections due to Pseudomonas aeruginosa: systematic review and meta-analysis
Rojas, A.
Palacios-Baena, Z. R.
Lopez-Cortes, L. E.
Rodriguez-Bano, J.
CLINICAL MICROBIOLOGY AND INFECTION, 2019, 25 (08) : 964 - 970

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