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

Authors :
Pedro María Martínez Pérez-Crespo
Álvaro Rojas
Joaquín Felipe Lanz-García
Pilar Retamar-Gentil
José María Reguera-Iglesias
Olalla Lima-Rodríguez
Alfonso del Arco Jiménez
Jonathan Fernández Suárez
Alfredo Jover-Saenz
Josune Goikoetxea Aguirre
Eva León Jiménez
María Luisa Cantón-Bulnes
Pilar Ortega Lafont
Carlos Armiñanzas Castillo
Juan Sevilla Blanco
Jordi Cuquet Pedragosa
Lucía Boix-Palop
Berta Becerril Carral
Alberto Bahamonde-Carrasco
Teresa Marrodan Ciordia
Clara Natera Kindelán
Isabel María Reche Molina
Carmen Herrero Rodríguez
Inés Pérez Camacho
David Vinuesa García
Fátima Galán-Sánchez
Alejandro Smithson Amat
Esperanza Merino de Lucas
Antonio Sánchez-Porto
Marcos Guzmán García
Inmaculada López-Hernández
Jesús Rodríguez-Baño
Luis Eduardo López-Cortés
on behalf of the PROBAC REIPI/GEIH-SEIMC/SAEI Group
Source :
Antibiotics, Vol 11, Iss 6, p 707 (2022)
Publication Year :
2022
Publisher :
MDPI AG, 2022.

Abstract

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.

Details

Language :
English
ISSN :
20796382
Volume :
11
Issue :
6
Database :
Directory of Open Access Journals
Journal :
Antibiotics
Publication Type :
Academic Journal
Accession number :
edsdoj.6be994af23df4ea58f3f530b9fc0609b
Document Type :
article
Full Text :
https://doi.org/10.3390/antibiotics11060707