title: Hospital mortality for patients with bacteremia due to Staphylococcus aureus or Pseudomonas aeruginosa.
abstract: OBJECTIVE
  To evaluate the relationship between hospital mortality and bloodstream infections due to Staphylococcus aureus or Pseudomonas aeruginosa.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  A 1,400-bed, university-affiliated urban teaching hospital.
  
  
  METHODS
  Between December 2001 and September 2002, 314 patients with bacteremia due to S aureus or P aeruginosa were prospectively evaluated.
  
  
  METHODS
  Prospective patient surveillance and data collection.
  
  
  RESULTS
  Thirteen patients (4.1%) received inadequate initial antibiotic treatment. Fifty-four patients (17.2%) died during hospitalization. Hospital mortality was statistically greater for patients with bloodstream infections due to P aeruginosa (n = 49) compared to methicillin-sensitive S aureus (MSSA) [n = 117; 30.6% vs 16.2%, p = 0.036] and methicillin-resistant S aureus (MRSA) [n = 148; 30.6% vs 13.5%, p = 0.007]. Multiple logistic regression analysis identified the lack of response to initial medical treatment (adjusted odds ratio [AOR], 2.69; 95% confidence interval [CI], 1.83 to 3.94; p = 0.010) and endocarditis (AOR, 4.62; 95% CI, 2.45 to 8.73; p = 0.016) as independent determinants of hospital mortality. Patients with bloodstream infections due to P aeruginosa were statistically more likely to be nonresponders to early medical treatment compared to patients with MSSA (73.5% vs 11.1%, p < 0.001) and MRSA (73.5% vs 16.9%, p < 0.001) bloodstream infections.
  
  
  CONCLUSIONS
  These data suggest that bloodstream infections due to P aeruginosa have a greater risk of hospital mortality compared to bloodstream infections due to S aureus despite adequate antibiotic treatment.
authors.affiliation: Pulmonary and Critical Care Division, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO 63110, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Osmon
authors.forename: Suzanne
authors.initials: S
authors.lastname: Ward
authors.forename: Victoria J
authors.initials: VJ
authors.lastname: Fraser
authors.forename: Marin H
authors.initials: MH
authors.lastname: Kollef
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality*; D017848:Blood-Borne Pathogens / Q000302:isolation & purification*; D002423:Cause of Death; D015331:Cohort Studies; D016001:Confidence Intervals; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006760:Hospitalization; D006784:Hospitals, Teaching / Q000706:statistics & numerical data*; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011336:Probability; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality*; D018570:Risk Assessment; D012720:Severity of Illness Index; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality*; D016019:Survival Analysis
chemical_list: D000900:Anti-Bacterial Agents