Pseudomonas aeruginosa Bloodstream Infections Presenting with Septic Shock in Neutropenic Cancer Patients

This large, multicenter, retrospective cohort study including onco-hematological neutropenic patients with Pseudomonas aeruginosa bloodstream infection (PABSI) found that among 1213 episodes, 411 (33%) presented with septic shock. The presence of solid tumors (33.3% vs. 20.2%, p < 0.001), a high-...

Descripción completa

Detalles Bibliográficos
Autores: Royo-Cebrecos, Cristina|||0000-0003-2554-4656, Laporte-Amargós, Júlia|||0000-0001-6114-7231, Peña, Marta, Ruiz-Camps, Isabel|||0000-0003-3743-2379, Garcia-Vidal, Carolina|||0000-0002-8915-0683, Abdala, Edson|||0000-0003-0765-6654, Oltolini, Chiara, Akova, Murat|||0000-0002-6904-9473, Montejo, Miguel, Mikulska, Malgorzata|||0000-0002-5535-4602, Martín-Dávila, Pilar|||0000-0002-7469-897X, Herrera, Fabián, Gasch Blasi, Oriol|||0000-0001-8518-458X, Drgona, Lubos|||0000-0002-5089-3201, Morales, Hugo Manuel Paz|||0000-0001-7913-8958, Brunel, Anne-Sophie|||0000-0001-9437-1977, García, Estefanía, Isler, Burcu, Kern, Winfried V., Palacios-Baena, Zaira R.|||0000-0002-1713-6807, de la Calle, Guillermo Maestro, Montero, María Milagro|||0000-0001-5991-6804, Kanj, Souha|||0000-0001-6413-3396, Sipahi, Oguz R., Calik, Sebnem, Márquez-Gómez, Ignacio|||0000-0002-9555-5767, Marin, Jorge I.|||0000-0002-6443-5076, Gomes, Marisa Z. R.|||0000-0001-6492-1034, Hemmatii, Philipp, Araos, Rafael|||0000-0001-8075-0626, Peghin, Maddalena|||0000-0002-4640-679X, Del Pozo, Jose Luis|||0000-0002-5402-3334, Yáñez, Lucrecia|||0000-0001-9925-3048, Tilley, Robert, Manzur, Adriana, Novo, Andrés, Carratalà, Jordi|||0000-0003-3209-2563, Gudiol, Carlota|||0000-0003-3095-4422
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:291892
Acceso en línea:https://ddd.uab.cat/record/291892
https://dx.doi.org/urn:doi:10.3390/microorganisms12040705
Access Level:acceso abierto
Palabra clave:Bacteremia
Bloodstream infection
Cancer
Neutropenia
Pseudomonas aeruginosa
Septic shock
Descripción
Sumario:This large, multicenter, retrospective cohort study including onco-hematological neutropenic patients with Pseudomonas aeruginosa bloodstream infection (PABSI) found that among 1213 episodes, 411 (33%) presented with septic shock. The presence of solid tumors (33.3% vs. 20.2%, p < 0.001), a high-risk Multinational Association for Supportive Care in Cancer (MASCC) index score (92.6% vs. 57.4%; p < 0.001), pneumonia (38% vs. 19.2% p < 0.001), and infection due to multidrug-resistant P. aeruginosa (MDRPA) (33.8% vs. 21.1%, p < 0.001) were statistically significantly higher in patients with septic shock compared to those without. Patients with septic shock were more likely to receive inadequate empirical antibiotic therapy (IEAT) (21.7% vs. 16.2%, p = 0.020) and to present poorer outcomes, including a need for ICU admission (74% vs. 10.5%; p < 0.001), mechanical ventilation (49.1% vs. 5.6%; p < 0.001), and higher 7-day and 30-day case fatality rates (58.2% vs. 12%, p < 0.001, and 74% vs. 23.1%, p < 0.001, respectively). Risk factors for 30-day case fatality rate in patients with septic shock were orotracheal intubation, IEAT, infection due to MDRPA, and persistent PABSI. Therapy with granulocyte colony-stimulating factor and BSI from the urinary tract were associated with improved survival. Carbapenems were the most frequent IEAT in patients with septic shock, and the use of empirical combination therapy showed a tendency towards improved survival. Our findings emphasize the need for tailored management strategies in this high-risk population.

Similares en LA Referencia