title: Multidrug-resistant Pseudomonas aeruginosa bloodstream infections: risk             factors and mortality.
abstract: We retrospectively studied patients diagnosed with P. aeruginosa bloodstream infections (BSIs) in two Italian university hospitals. Risk factors for the isolation of multidrug-resistant (MDR) or non-MDR P. aeruginosa in blood cultures were identified by a case-case-control study, and a cohort study evaluated the clinical outcomes of such infections. We identified 106 patients with P. aeruginosa BSI over the 2-year study period; 40 cases with MDR P. aeruginosa and 66 cases with non-MDR P. aeruginosa were compared to 212 controls. Independent risk factors for the isolation of MDR P. aeruginosa were: presence of central venous catheter (CVC), previous antibiotic therapy, and corticosteroid therapy. Independent risk factors for non-MDR P. aeruginosa were: previous BSI, neutrophil count <500/mm3, urinary catheterization, and presence of CVC. The 21-day mortality rate of all patients was 33·9%. The variables independently associated with 21-day mortality were presentation with septic shock, infection due to MDR P. aeruginosa, and inadequate initial antimicrobial therapy.
authors.affiliation: Institute of Infectious Diseases, Catholic University of the Sacred                     Heart, Roma, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Tumbarello
authors.forename: E
authors.initials: E
authors.lastname: Repetto
authors.forename: E M
authors.initials: EM
authors.lastname: Trecarichi
authors.forename: C
authors.initials: C
authors.lastname: Bernardini
authors.forename: G
authors.initials: G
authors.lastname: De Pascale
authors.forename: A
authors.initials: A
authors.lastname: Parisini
authors.forename: M
authors.initials: M
authors.lastname: Rossi
authors.forename: M P
authors.initials: MP
authors.lastname: Molinari
authors.forename: T
authors.initials: T
authors.lastname: Spanu
authors.forename: C
authors.initials: C
authors.lastname: Viscoli
authors.forename: R
authors.initials: R
authors.lastname: Cauda
authors.forename: M
authors.initials: M
authors.lastname: Bassetti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D055499:Catheter-Related Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000302:isolation & purification*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents