Improved prognosis of Pseudomonas aeruginosa bacteremia in 127 consecutive neutropenic patients with hematologic malignancies.
OBJECTIVE
Although decreasing in frequency, Pseudomonas aeruginosa bacteremia is still a major challenge for neutropenic cancer patients. In patients with hematologic malignancies, the prognosis of P. aeruginosa bacteremia is particularly poor due to the prolonged and severe neutropenia, mucosal damage, and other defects in immunity related both to the underlying disease and to the cytotoxic therapy.


METHODS
To verify the outcome of P. aeruginosa bacteremia and to try to define possible prognostic factors, the authors reviewed the medical records of 127 consecutive episodes of P. aeruginosa bacteremia observed in the hematologic unit of the Verona University School of Medicine.


RESULTS
Presence of pneumonia and septic shock, persistence and severity of neutropenia, delayed and inappropriate antibiotic therapy, and unresponsive underlying disease had negative impact on clinical outcome of P. aeruginosa bacteremia.


CONCLUSIONS
With recognition of the risk factors and more careful management, the prognosis of P. aeruginosa bacteremia in neutropenic patients with hematologic malignancies has improved in recent years.
Todeschini
G
G
Department of Hematology, Verona University School of Medicine, Verona, Italy.
Franchini
M
M
Tecchio
C
C
Meneghini
V
V
Pizzolo
G
G
Veneri
D
D
Murari
C
C
Ricetti
M M
MM
Perona
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality; D002511:Cephalosporins / Q000627:therapeutic use; D002648:Child; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality; D011379:Prognosis; D011552:Pseudomonas Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality; D011550:Pseudomonas aeruginosa; D012189:Retrospective Studies; D012307:Risk Factors
D000900:Anti-Bacterial Agents; D002511:Cephalosporins