title: Risk factors, clinical features, and outcome of Pseudomonas aeruginosa bacteremia in patients with hematologic malignancies: a case-control study.
abstract: BACKGROUND
  We observed an increased rate of Pseudomonas aeruginosa bacteremia in our hematology unit in 2004-2007 without an identified environmental source.
  
  
  METHODS
  We conducted a matched case-control study to investigate factors associated with P aeruginosa bacteremia in patients with hematologic malignancies.
  
  
  RESULTS
  Forty-two episodes of P aeruginosa bacteremia were identified. At presentation, 26 patients (62%) had pneumonia and 9 patients (21%) were in shock. Twenty-five patients (60%) were aplastic. The clinical cure rate was 40%. Comparing the 42 cases with 84 matched controls identified the following independent risk factors for P aeruginosa bacteremia: hospitalization in the previous 3 months (odds ratio [OR], 12.84; 95% confidence interval [CI], 2.98-55.18), antibiotic therapy in the previous 3 months (OR, 5.34; 95% CI, 2.14-13.30), receipt of ceftriaxone in the previous 3 months (OR, 2.38; 95% CI, 1.08-5.27), receipt of aminoglycosides in the previous 3 months (OR, 6.65; 95% CI, 1.15-38.25) and receipt of fluoroquinolones in the previous 3 months (OR, 3.22; 95% CI, 1.48-7.00).
  
  
  CONCLUSIONS
  Local antibiotic therapy algorithms were modified to decrease prescriptions of ceftriaxone and combination therapy with aminoglycosides and fluoroquinolones in an effort to decrease the risk of P aeruginosa bacteremia.
authors.affiliation: Department of Infectious Diseases, Claude Huriez Hospital, University of Lille, France. fannyvuotto@free.fr
authors.forename: Fanny
authors.initials: F
authors.lastname: Vuotto
authors.forename: Céline
authors.initials: C
authors.lastname: Berthon
authors.forename: Nadine
authors.initials: N
authors.lastname: Lemaitre
authors.forename: Alain
authors.initials: A
authors.lastname: Duhamel
authors.forename: Sandy
authors.initials: S
authors.lastname: Balkaran
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Le Ray
authors.forename: Jean Baptiste
authors.initials: JB
authors.lastname: Micol
authors.forename: Karine
authors.initials: K
authors.lastname: Faure
authors.forename: Serge
authors.initials: S
authors.lastname: Alfandari
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000617:Aminoglycosides / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D016022:Case-Control Studies; D002443:Ceftriaxone / Q000008:administration & dosage; D002648:Child; D015897:Comorbidity; D005260:Female; D024841:Fluoroquinolones / Q000008:administration & dosage; D019337:Hematologic Neoplasms / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D011550:Pseudomonas aeruginosa / Q000187:drug effects*; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D002443:Ceftriaxone