title: Pseudomonas aeruginosa bacteremia in children over ten consecutive years: analysis of clinical characteristics, risk factors of multi-drug resistance and clinical outcomes.
abstract: This study aimed to evaluate the clinical profiles, antibiotic susceptibility, risk factors of multi-drug resistance (MDR) and outcomes of P. aeruginosa bacteremia in children by retrospective methods at a tertiary teaching children's hospital in Seoul, Korea during 2000-2009. A total of 62 episodes were evaluated and 59 patients (95.2%) had underlying diseases. Multivariate analysis demonstrated that an intensive care unit (ICU) stay within the previous one month was the only independent risk factor for MDR P. aeruginosa bacteremia (odds ratio [OR], 6.8; 95% confidence interval [CI], 1.3-35.8, P = 0.023). The overall fatality rate associated with P. aeruginosa bacteremia was 14.5% (9 of 62). The fatality rate in patients with MDR P. aeruginosa was 57.1%, compared with 9.1% in non-MDR patients (OR 13.3; 95% CI 2.3-77.2, P = 0.006). However, the presence of respiratory difficulty was the only independent risk factor for overall fatality associated with P. aeruginosa bacteremia according to multivariate analysis (OR 51.0; 95% CI 7.0-369.0, P < 0.001). A previous ICU stay and presentation with respiratory difficulty were associated with acquisition of MDR P. aeruginosa and a higher fatality rate, respectively. Future efforts should focus on the prevention and treatment of P. aeruginosa bacteremia in high-risk children.
authors.affiliation: Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.
authors.forename: Mi Ae
authors.initials: MA
authors.lastname: Yang
authors.forename: Jina
authors.initials: J
authors.lastname: Lee
authors.forename: Eun Hwa
authors.initials: EH
authors.lastname: Choi
authors.forename: Hoan Jong
authors.initials: HJ
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D016470:Bacteremia / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D008297:Male; D008826:Microbial Sensitivity Tests; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects*; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome