Microorganisms (Mar 2024)
<i>Pseudomonas aeruginosa</i> Bloodstream Infections Presenting with Septic Shock in Neutropenic Cancer Patients: Impact of Empirical Antibiotic Therapy
- Cristina Royo-Cebrecos,
- Júlia Laporte-Amargós,
- Marta Peña,
- Isabel Ruiz-Camps,
- Carolina Garcia-Vidal,
- Edson Abdala,
- Chiara Oltolini,
- Murat Akova,
- Miguel Montejo,
- Malgorzata Mikulska,
- Pilar Martín-Dávila,
- Fabián Herrera,
- Oriol Gasch,
- Lubos Drgona,
- Hugo Manuel Paz Morales,
- Anne-Sophie Brunel,
- Estefanía García,
- Burcu Isler,
- Winfried V. Kern,
- Zaira R. Palacios-Baena,
- Guillermo Maestr de la Calle,
- Maria Milagro Montero,
- Souha S. Kanj,
- Oguz R. Sipahi,
- Sebnem Calik,
- Ignacio Márquez-Gómez,
- Jorge I. Marin,
- Marisa Z. R. Gomes,
- Philipp Hemmatii,
- Rafael Araos,
- Maddalena Peghin,
- Jose L. Del Pozo,
- Lucrecia Yáñez,
- Robert Tilley,
- Adriana Manzur,
- Andrés Novo,
- Jordi Carratalà,
- Carlota Gudiol
Affiliations
- Cristina Royo-Cebrecos
- Internal Medicine Department, Hospital Nostra Senyora de Meritxell, SAAS, AD700 Escaldes-Engordany, Andorra
- Júlia Laporte-Amargós
- Infectious Diseases Department, Bellvitge University Hospital, IDIBELL, 08907 Barcelona, Spain
- Marta Peña
- Haematology Department, Institute Català d’Oncologia (ICO)–Hospital Duran i Reynals, IDIBELL, 08908 Barcelona, Spain
- Isabel Ruiz-Camps
- Infectious Diseases Department, Vall d’Hebron University Hospital, 08035 Barcelona, Spain
- Carolina Garcia-Vidal
- Infectious Diseases Department, Hospital Clínic i Provincial, 08036 Barcelona, Spain
- Edson Abdala
- Instituto do Cancer do Estado de São Paulo, Faculty of Medicine, Univesity of São Paulo, Sao Paulo 01246, Brazil
- Chiara Oltolini
- Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
- Murat Akova
- Department of Infectious Diseases, Hacettepe University School of Medicine, 06100 Ankara, Turkey
- Miguel Montejo
- Infectious Diseases Unit, Cruces University Hospital, 48903 Bilbao, Spain
- Malgorzata Mikulska
- Division of Infectious Diseases, Ospedale Policlinico San Martino, University of Genoa (DISSAL), 16132 Genoa, Italy
- Pilar Martín-Dávila
- Infectious Diseases Department, Ramon y Cajal Hospital, 28034 Madrid, Spain
- Fabián Herrera
- Infectious Diseases Section, Department of Medicine, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires C1430EFA, Argentina
- Oriol Gasch
- Infectious Diseases Department, Hospital Universitari Parc Taulí, Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
- Lubos Drgona
- Oncohematology Department, National Cancer Institute, Comenius University, 81499 Bratislava, Slovakia
- Hugo Manuel Paz Morales
- Infectious Diseases Department, Hospital Erasto Gaertner, Curitiba 81520-060, Brazil
- Anne-Sophie Brunel
- Infectious Diseases and Medicine Department, Lausanne University Hospital, CHUV, 1011 Lausanne, Switzerland
- Estefanía García
- Haematology Department, Reina Sofía University Hospital-IMIBIC-UCO, 14004 Córdoba, Spain
- Burcu Isler
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Education and Research Hospital, 34668 Istanbul, Turkey
- Winfried V. Kern
- Division of Infectious Diseases, Department of Medicine II, Faculty of Medicine, University of Freiburg Medical Center, 79110 Freiburg, Germany
- Zaira R. Palacios-Baena
- Unit of Infectious Diseases and Clinical Microbiology, Institute of Biomedicine of Seville (IBIS), Virgen Macarena University Hospital, 41013 Seville, Spain
- Guillermo Maestr de la Calle
- Infectious Diseases Unit, Instituto de Investigación Hospital “12 de Octubre” (i + 12), School of Medicine, “12 de Octubre” University Hospital, Universidad Complutense, 28041 Madrid, Spain
- Maria Milagro Montero
- Infectious Pathology and Antimicrobials Research Group (IPAR), Infectious Diseases Service, Hospital del Mar, Institut Hospital del Mar d’Investigations Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, 08003 Barcelona, Spain
- Souha S. Kanj
- Infectious Diseases Division, American University of Beirut Medical Center, Beirut 110236, Lebanon
- Oguz R. Sipahi
- Faculty of Medicine, Ege University, 35040 Izmir, Turkey
- Sebnem Calik
- Department of Infectious Diseases and Clinical Microbiology, University of Health Science Izmir Bozyaka Training and Research Hospital, 35170 Izmir, Turkey
- Ignacio Márquez-Gómez
- Infectious Diseases Department, Hospital Regional de Málaga, 29010 Málaga, Spain
- Jorge I. Marin
- Infectious Diseases and Clinical Microbiology Department, Clínica Maraya, Manizales 170001-17, Colombia
- Marisa Z. R. Gomes
- Hospital Federal dos Servidores do Estado, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Ministério da Saúde, Rio de Janeiro 20221-161, Brazil
- Philipp Hemmatii
- Department of Hematology, Oncology and Palliative Care, Klinikum Ernst von Bergmann, Academic Teaching Hospital of Charité University Medical School, 10117 Berlin, Germany
- Rafael Araos
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago de Chile 12461, Chile
- Maddalena Peghin
- Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, 21100 Varese, Italy
- Jose L. Del Pozo
- Infectious Diseases and Microbiology Unit, Navarra University Clinic, 31008 Pamplona, Spain
- Lucrecia Yáñez
- Haematology Department, Marqués de Valdecilla University Hospital, 39008 Santander, Spain
- Robert Tilley
- Microbiology Department, University Hospitals Plymouth NHS Trust, Plymouth PL6 8DH, UK
- Adriana Manzur
- Infectious Diseases, Hospital Rawson, San Juan J5400, Argentina
- Andrés Novo
- Haematology Department, Son Espases University Hospital, 07120 Palma de Mallorca, Spain
- Jordi Carratalà
- Infectious Diseases Department, Bellvitge University Hospital, IDIBELL, 08907 Barcelona, Spain
- Carlota Gudiol
- Infectious Diseases Department, Bellvitge University Hospital, IDIBELL, 08907 Barcelona, Spain
- DOI
- https://doi.org/10.3390/microorganisms12040705
- Journal volume & issue
-
Vol. 12,
no. 4
p. 705
Abstract
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 p p P. aeruginosa (MDRPA) (33.8% vs. 21.1%, p p = 0.020) and to present poorer outcomes, including a need for ICU admission (74% vs. 10.5%; p p p 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.
Keywords
