Journal article
Systemic inflammatory response syndrome in adult patients with nosocomial bloodstream infection due to Pseudomonas aeruginosa
Journal of Infection, Vol.53(1), pp.30-35
2006
DOI: 10.1016/j.jinf.2005.08.032
PMID: 16253333
Abstract
To evaluate relationships between the inflammatory response, clinical course, and outcome of nosocomial BSI due to Pseudomonas aeruginosa. 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. 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. 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.
Details
- Title: Subtitle
- Systemic inflammatory response syndrome in adult patients with nosocomial bloodstream infection due to Pseudomonas aeruginosa
- Creators
- Alexandre R Marra - Division of Infectious Diseases, Brazil (UNIFESP-EPM)/Hospital São Paulo (HSP), Universidade Federal de São Paulo, São Paulo, BrazilKatharine Bar - Department of Internal Medicine, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA 23298, USAGonzalo M.L Bearman - Department of Internal Medicine, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA 23298, USARichard P Wenzel - Department of Internal Medicine, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA 23298, USAMichael B Edmond - Department of Internal Medicine, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA 23298, USA
- Resource Type
- Journal article
- Publication Details
- Journal of Infection, Vol.53(1), pp.30-35
- Publisher
- Elsevier Ltd
- DOI
- 10.1016/j.jinf.2005.08.032
- PMID
- 16253333
- ISSN
- 0163-4453
- eISSN
- 1532-2742
- Language
- English
- Date published
- 2006
- Academic Unit
- Infectious Diseases; Internal Medicine
- Record Identifier
- 9983905641202771
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