Systemic inflammatory response syndrome in adult patients with nosocomial bloodstream infection due to Pseudomonas aeruginosa - 17/08/11
, Katharine Bar b, Gonzalo M.L. Bearman b, Richard P. Wenzel b, Michael B. Edmond b
Corresponding author. Address: 1201 East Marshall Street, A.D. Williams Clinic, 6th Floor, Room 6-602, P.O. Box 980019, Richmond, VA 23298, USA. Tel.: +1 804 828 2121; fax: +1 804 828 2125.Summary |
Objectives |
To evaluate relationships between the inflammatory response, clinical course, and outcome of nosocomial BSI due to Pseudomonas aeruginosa.
Methods |
We performed a historical cohort study on 77 adults with P. aeruginosa (Pa) nBSI to define the associated systemic inflammatory response syndrome (SIRS). We examined SIRS scores 2 days prior through 14 days after the first positive blood culture. Imipenem resistant—IRPa (n=20) and susceptible infections—ISPa (n=57) were compared. Variables significant in univariate analysis were entered into a logistic regression model.
Results |
Seventy-four percent of BSI were ISPa and 26.0% by IRPa. Septic shock occurred in 39.0%. Crude mortality was 48.1%. There was no difference in APACHE II (AP2) scores on days −2, −1 and 0 between the ISPa and IRPa groups. Multivariate analysis revealed that AP2≥20 at BSI onset (P<0.001) and hematologic failure (P=0.001) independently predicted death.
Conclusions |
In patients with P. aeruginosa nBSI, the incidence of septic shock and organ failure is high; patients with IRPa BSI are not more acutely ill prior to infection than those with ISPa BSI and outcome is not significantly different; AP2≥20 at BSI onset and the development of hematologic failure are independent predictors of death.
Le texte complet de cet article est disponible en PDF.Keywords : Pseudomonas aeruginosa, Systemic inflammatory response, Bloodstream infection, Imipenem resistance
Plan
Vol 53 - N° 1
P. 30-35 - juillet 2006 Retour au numéro
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