Pseudomonas Aeruginosa Bacteremia in Patients With Hematologic Malignancies

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Abstract

Introduction

Pseudomonas aeruginosa is a gram-negative rod that is a major cause of bacteremia in patients with a hematologic malignancy. Neutropenia from induction chemotherapy is the main risk factor for P. aeruginosa bacteremia and sepsis in this population. We analyzed risk factors, antibiotic susceptibility patterns, and outcomes due to P. aeruginosa bacteremia in these patients from our institution and compared these with those of similar studies.

Methods

This is a retrospective chart review analyzing P. aeruginosa bacteremia in patients with hematologic malignancies.

Results

Between January 2012 and February 2016, a total of 71 patients met the requirements for inclusion in our study. The average age of study participants was 57.9 years. Of the 71 patients included, 43 (60.6%) were neutropenic at the time of positive blood culture, 28 (39.4%) were not neutropenic at the time of positive of blood culture, 23 (32.4%) developed either sepsis or severe sepsis during the course of their hospital stay, 8 (11.3%) developed septic shock, 10 (14.1%) required vasopressor administration, 8 (11.3%) required mechanical ventilation, and 6 (8.5%) required both vasopressor administration and mechanical ventilation.

Discussion

Our research reaffirms the general severity of P. aeruginosa infections. Ultimately, 9 of 71 patients died as a result of their infection, with a mortality rate of 12.7%. Individuals whose bacteremia progressed to septic shock were much more likely to die. The case fatality rate of septic shock was 62.5%. Our data are congruent with other research that finds advanced age to be a significant risk factor for mortality. Our study also found that individuals who received a bone marrow transplant before developing bacteremia were more likely to survive than individuals who did not receive a bone marrow transplant.

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