title: Pseudomonas aeruginosa bacteremia in patients with AIDS.
abstract: Twenty-seven episodes of Pseudomonas aeruginosa bacteremia in 21 patients with AIDS were evaluated at the Mount Sinai Medical Center in 1987-1992. Of 21 primary episodes, 12 were acquired in the community, 8 were nosocomial, and one was acquired in a nursing home. Sources of bacteremia (i.e., sites of infection; n = 30) included the lungs (12 cases) an indwelling vascular catheter (9), and the upper respiratory tract (5, including 2 cases of sinusitis, 2 cases of malignant external otitis, and 1 case of epiglottis/pharyngeal cellulitis); in 4 cases the source was unknown. White blood cell counts ranged from 0.1 to 26.2 (mean, 4.32) x 10(3)/mm3; in 19 of 26 cases, the absolute neutrophil count was > 1 x 10(3)/mm3. With the exclusion of primary episodes of bacteremia that resulted in death, the rate of relapse was 33.3% (5 of 15 cases). Mortality for the 25 evaluable episodes of bacteremia was 40% (32% for primary infection and 80% for relapse; P = .06); 52.6% of evaluable patients (10 of 19) ultimately died of P. aeruginosa bacteremia. The institution of appropriate therapy at presentation did not positively affect outcome. Rates of response were higher among episodes treated with a drug combination (an antipseudomonal beta-lactam or monobactam antibiotic plus an aminoglycoside) than among those treated with a single agent (P = .036).
authors.affiliation: Department of Medicine, Mount Sinai School of Medicine, New York, New York 10029.
authors.forename: M H
authors.initials: MH
authors.lastname: Mendelson
authors.forename: A
authors.initials: A
authors.lastname: Gurtman
authors.forename: S
authors.initials: S
authors.lastname: Szabo
authors.forename: E
authors.initials: E
authors.lastname: Neibart
authors.forename: B R
authors.initials: BR
authors.lastname: Meyers
authors.forename: M
authors.initials: M
authors.lastname: Policar
authors.forename: T W
authors.initials: TW
authors.lastname: Cheung
authors.forename: D
authors.initials: D
authors.lastname: Lillienfeld
authors.forename: G
authors.initials: G
authors.lastname: Hammer
authors.forename: S
authors.initials: S
authors.lastname: Reddy
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000382:microbiology*; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D000900:Anti-Bacterial Agents; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality; D011550:Pseudomonas aeruginosa; D012008:Recurrence
chemical_list: D000900:Anti-Bacterial Agents