[P. aeruginosa bacteremias: analysis of prognostic factors. A prospective study, 1992-1998].
BACKGROUND
P. aeruginosa causes serious infections with high mortality.


OBJECTIVE
Identify the prognostic factors associated with higher mortality in P. aeruginosa bacteremias (PAB).


METHODS
211 consecutive cases of PAB were analyzed prospectively between 1992-1998. Blood cultures, isolation, and antimicrobial sensitivity were carried out according to microbiology standard methodology. The variables analyzed as prognostic factors were: sex, age, source of infection, background, main disease, initial clinical severity, foci, presence of complications, leukocyte count, type of antibiotic treatment and adaptation. Bivariate and multivariate statistical analyses were carried out by the method of logistic regression.


RESULTS
Global mortality was 27.96%; factors associated with higher mortality in the bivariate study were main disease rapidly and eventually fatal, diabetes, a situation of critical initial clinical severity, lung focus, complications, neutropenia and inadequate antibiotic treatment. The logistic regression study, the critical initial clinical severity, and the presence of complications were the variables associated with worse prognosis. We did not find significant differences in the evolution among the patients who received monotherapy and those on combinations of antimicrobial drugs against pseudomonas.


CONCLUSIONS
Higher mortality of PAB is statistically associated to the situation of critical initial clinical severity and to the presence of complications; therefore, an early diagnosis and adequate treatment to improve the morbidity and mortality are recommended.
Gómez Gómez
J
J
Servicios de Medicina Interna y Enfermedades Infecciosas, Hospital Universitario Virgen de la Arrixaca.
Alcántara Villar
M
M
Simarro Córdoba
E
E
Martínez Vicente
B
B
Ruiz Gómez
J
J
Guerra Pérez
B
B
Herrero Martínez
J A
JA
Canteras Jordana
M
M
Valdés Chavarri
M
M
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; 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; D011379:Prognosis; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
D000900:Anti-Bacterial Agents
Bacteriemias por P. aeruginosa: análisis de los factores pronóstico. Estudio prospectivo 1992-1998.