[Pseudomonas aeruginosa bacteremia associated with hematologic disorders [III]. Prognostic factors].
We reviewed 57 episodes of Pseudomonas aeruginosa bacteremia in 55 patients with hematologic disorders such as acute leukemia during a 16-year period, focusing especially on the prognosis. Survival at one week after onset was observed in only 39% of the episodes. Prognosis was significantly better in patients with unimicrobial bacteremia than in those with polymicrobial bacteremia (21/42 vs 1/15, p less than 0.01), in patients without shock than in those with shock (13/21 vs 9/36, p less than 0.02), in patients with granulocyte count at onset of at least 100/mm3 than in those with more marked granulocytopenia (10/13 vs 12/44, p less than 0.01), in patients with an increase in granulocyte count by at least 100/mm3 during their infection than in those without any subsequent increase (18/18 vs 4/13, p less than 0.001), and in patients with total serum protein level at onset of at least 6.0 g/dl than in those with hypoproteinemia (18/32 vs 4/25, p less than 0.01). Patients with bacteremia secondary to urogenital infection tended to have a higher one-week survival rate than those with pneumonia followed by bacteremia (4/8, 50% vs 2/9, 22%). With regard to the antibiotic treatment of unimicrobial bacteremia, 14 (70%) of 20 patients receiving therapy with one or two anti-pseudomonal beta-lactam antibiotics and an aminoglycoside in combination that were effective in vitro against the infecting organism survived, and so did only seven (32%) of 22 patients receiving therapy with either one in vitro effective beta-lactam or aminoglycoside or inadequate drugs (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Funada
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Machi
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Matsuda
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D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007938:Leukemia / Q000150:complications*; D008223:Lymphoma / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011552:Pseudomonas Infections / Q000209:etiology*; D018805:Sepsis / Q000209:etiology*