A Retrospective Analysis of Risk Factors and Patient Outcomes of Pseudomonas aeruginosa Bloodstream Infections in a Chinese Tertiary Hospital

Abstract

Abstract Purpose Pseudomonas aeruginosa(PA) is a common pathogen that causes bloodstream infections (BSI).This study aimed to investigate the risk factors and clinical outcomes of BSI caused by PA. Methods A single-center retrospective study was conducted to analyze the risk factors and outcomes of PA BSI at a Chinese tertiary hospital over a 10-year period. The clinical characteristics and outcomes of patients who received a sequential organ function assessment (SOFA) score < 4 were compared with those of patients who received a SOFA score ≥4. Results During the 10-year period, 174 eligible patients with PA BSI were included in the study, 95 of whom had a SOFA score of < 4. Multivariate analysis revealed that Pitt score, adjusted Charlson comorbidity index > 6 points, and empirical imipenem treatment were independent risk factors for 14-day treatment failure in patients with PA BSI having a SOFA score ≥ 4 points. Empirical imipenem treatment and ICU admission were independent risk factors for 14-day treatment failure in patients with PA BSI having a SOFA score < 4. Prior exposure to antimicrobials and SOFA score were significantly associated with 30-day mortality in the PA BSI population. Using Kaplan-Meier survival analysis, we found no significant difference in clinical outcomes between patients receiving definitive β-lactam/β-lactamase inhibitor combinations (BLICs), and carbapenems (P=0.874). Conclusion The empirical use of imipenem was an independent risk factor for 14-day treatment failure. Our results suggest that clinicians empirically treat patients based on a combination of their condition, history of antibiotic exposure, and the likelihood of drug susceptibility to the most likely pathogens. No significant divergence in clinical outcomes was observed between patients treated with carbapenems and BLICs as definitive treatment for PA bacteremia.