Pseudomonas bacteremia. Retrospective analysis of 410 episodes.
We reviewed 410 episodes of Pseudomonas bacteremia occurring in patients with cancer during a ten-year period. Pseudomonas bacteremia was most common among patients with acute leukemia. The majority of patients acquired their infections in the hospital, and 51% had received antibiotic therapy for other presumed or proved infection during the preceding week. Shock occurred in 33%, and 32% had concomitant pneumonia. The overall cure rate was 62%; it was 67% for patients receiving appropriate antibiotics but only 14% for those receiving inappropriate antibiotics. A one- to two-day delay in the administration of appropriate antibiotic therapy reduced the cure rate from 74% to 46%. Patients who received an antipseudomonal beta-lactam antibiotic with or without an aminoglycoside had a significantly higher cure rate than patients who received only an aminoglycoside (72% and 71% vs 29%). Patients with shock, pneumonia, or persistent neutropenia had a substantially poorer prognosis.
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000617:Aminoglycosides / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D007769:Lactams; D007938:Leukemia / Q000150:complications; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D011379:Prognosis; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality; D011550:Pseudomonas aeruginosa / Q000187:drug effects; D012189:Retrospective Studies; D018805:Sepsis / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality; D013997:Time Factors
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D007769:Lactams