<i>Pseudomonas aeruginosa</i> Bacteremia among Immunocompetent and Immunocompromised Patients: Relation to Initial Antibiotic Therapy and Survival

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Author(s)

    • Migiyama Yohei Migiyama Yohei
    • Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences|Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences|Department of Respiratory Medicine, Kumamoto University Graduate School of Medical Sciences
    • Harada Yosuke Kohno Shigeru
    • Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences|Global COE Program, Nagasaki University
    • Nagaoka Kentaro Kaku Norihito
    • Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences|Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences
    • Morinaga Yoshitomo Harada Yosuke
    • Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences|Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences
    • Akamatsu Norihiko Yamada Koichi
    • Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences|Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences
    • Matsuda Junichi Nagaoka Kentaro
    • Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences|Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences
    • Izumikawa Koichi Morinaga Yoshitomo
    • Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences|Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences

Abstract

<i>Pseudomonas aeruginosa</i> bacteremia occurs mainly in immunocompromised patients. However, <i>P. aeruginosa</i> bacteremia in immunocompetent patients has also been reported. The aim of this study was to evaluate the clinical characteristics of <i>P. aeruginosa</i> bacteremia in relation to the immune status of the patients. The medical records of 126 adult patients with <i>P. aeruginosa</i> bacteremia in Nagasaki University Hospital were retrospectively reviewed between January 2003 and December 2012. Of 126 patients with <i>P. aeruginosa</i> bacteremia, 60 patients (47.6%) were classified as immunocompetent. Mortality in immunocompetent patients tended to be lower than in immunocompromised patients (7-day mortality, 8% vs. 30%, <i>P</i> < 0.01; 30-day mortality, 23% vs. 39%, <i>P</i> = 0.053). Multivariate analysis showed that a higher sequential organ failure assessment score (hazard ratio [HR]: 1.27, <i>P</i> < 0.01) and underlying malignancies (HR: 3.33, <i>P</i> < 0.01) were independently associated with 30-day mortality. Initial antibiotic therapy (HR: 0.21, <i>P</i> < 0.01) and patients' immune status (HR: 0.29, <i>P</i> = 0.02) also had a significant impact on survival. However, there was a significant interaction between these 2 variables (<i>P</i> = 0.03 for interaction). A subgroup analysis showed that in immunocompromised, but not immunocompetent patients, initial appropriate antibiotic therapy was associated with lower mortality (30-day mortality 20.5% vs. 66.7%, <i>P</i> < 0.01 by log-rank test).

Journal

  • Japanese Journal of Infectious Diseases

    Japanese Journal of Infectious Diseases 69(2), 91-96, 2016

    National Institute of Infectious Diseases, Japanese Journal of Infectious Diseases Editorial Committee

Codes

  • NII Article ID (NAID)
    130005138559
  • NII NACSIS-CAT ID (NCID)
    AA1132885X
  • Text Lang
    ENG
  • ISSN
    1344-6304
  • NDL Article ID
    027210963
  • NDL Call No.
    Z53-C450
  • Data Source
    NDL  J-STAGE 
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