Clinical Analysis Of 251 Cases Of Pseudomonas Aeruginosa Bloodstream Infection

Objective To review clinical characteristics and risk factors of Pseudomonas Aeruginosa(P.Aeruginosa)bloodstream infection.Methods Clinical data of P.Aeruginosa bloodstream infection in the First Affiliated Hospital of Soochow University from January 2007 to December 2016 were analyzed retrospectively.Results Among the 251 patients,178 patients were male,73 patients were female,the average age was 50.6±20.7 years old;APACHE Ⅱ score on admission was 11.5±5.2;247(98.4%)patients had fever;leukopenia was found in 125 patients,and leukocytosis was found in 87 patients,neutrophilopenia in 122 patients,and agranulocytosis in 113 patients,anaemia in 193 patients and hypoalbuminemia in 120 patients.There were at least one kind underlying disease in 219 patients,most of which were malignant hematoplastic,malignant solid tumor.229 patients had invasive procedures such as deep vein puncture,urinary catheter,mechanical ventilation etc.before blood sampling.P.Aeruginosa was isolated from 108 of the 173 deep venous catheters.130 patients received radiation or chemotherapy,immunosuppressive agents were used in 124 patients.Among the 251 strains of P.Aeruginosa,86.9% were susceptible to amikacin,followed by ciprofloxacin(85.6%)and cefepime(81.6%).Multidrug-resistant P.Aeruginosa was isolated from 36(14.3%)patients,and extensively drug resistant strain was isolated from 7 patients.All of the 251 patients were treated with antimicrobial agents,mainly composed of β-lactam /β-lactamase inhibitor combinations,carbapenems or fluoroquinolones.Among the 251 patients,20(8%)patients died,37(14.7%)refused further therapy due to worsening condition,and 194(77.3%)improved.Binary logistic regression analysis showed that high APACHEⅡ score on admission,amenia and hypoalbuminemia were risk factors for non-improved of bloodstream infection caused by P.Aeruginosa.Conclusions P.Aeruginosa bloodstream infection occurs in patients of immunocompromised more often,high APACHE Ⅱ score on admission,amenia andhypoalbuminemia are associated with poor prognosis.Appropriate empiric antimicrobial treatment as early as possible can improve the prognosis of P.Aeruginosa bloodstream infection.