Related Experiment Video
Updated: May 24, 2026
Replication of the Ordered, Nonredundant Library of Pseudomonas aeruginosa strain PA14 Transposon Insertion Mutants
Published on: May 4, 2018
P. aeruginosa bloodstream infections among hematological patients: an old or new question?
Chiara Cattaneo1, F Antoniazzi, S Casari
1Dept. of Haematology, Spedali Civili, Piazza Spedali Civili, 25100 Brescia, Italy. chiara.cattaneo@libero.it
Abstract:
Pseudomonas aeruginosa is a well-known cause of severe and potentially life-threatening infections among hematological patients. A prospective epidemiological surveillance program ongoing at our Hematology Unit revealed an increase over time of P. aeruginosa bloodstream infections (BSI). Their impact on outcome and antibiotic susceptibility was analyzed. BSI which consecutively occurred at our institution during a 70-month period were evaluated and correlated with type of pathogen, status of underlying disease, neutropenia, previous antibiotic therapy, resistance to antibiotics, and outcome. During the observation period, 441 BSI were recorded. Frequency of Gram-negative BSI was higher than that of other pathogens (57.3%). Overall, 66 P. aeruginosa BSI were recorded; 22 out of 66 were multiresistant (MR P. aeruginosa). Thirty-day mortality for all BSI was 11.3%; it was 27.3% for P. aeruginosa BSI and 36.4% for MR P. aeruginosa. At multivariate analysis, only active hematological disease and P. aeruginosa BSI were associated to an increased risk of death. For MR P. aeruginosa, BSI mortality was 83.3% vs. 18.8% when empiric therapy included or not an antibiotic with in vitro activity against P. aeruginosa (p=0.011). Together with active disease, the emergence of P. aeruginosa BSI, particularly if multiresistant, was responsible for an increased risk of death among hematological patients at our institution. In this scenario, reconsidering the type of combination antibiotic therapy to be used as empiric treatment of neutropenic fever was worthwhile.
Insights
Pseudomonas aeruginosa bloodstream infections (BSI) are increasing in hematological patients. Multiresistant P. aeruginosa significantly raises mortality, highlighting the need for effective empiric antibiotic therapy.
Area of Science:
- Infectious Diseases
- Hematology
- Epidemiology
Background:
- Pseudomonas aeruginosa is a significant pathogen causing severe infections in hematological patients.
- An increasing trend of P. aeruginosa bloodstream infections (BSI) was observed in a Hematology Unit.
- These infections pose a substantial threat to patient outcomes.
Purpose of the Study:
- To analyze the impact of P. aeruginosa BSI on patient outcomes and antibiotic susceptibility.
- To identify risk factors associated with increased mortality in hematological patients with BSI.
- To evaluate the effectiveness of empiric antibiotic therapy against P. aeruginosa.
Main Methods:
- Prospective epidemiological surveillance over a 70-month period.
- Evaluation of 441 bloodstream infections (BSI).
- Correlation analysis of pathogen type, disease status, neutropenia, prior antibiotics, resistance, and outcomes. Multivariate analysis was performed.
Main Results:
- P. aeruginosa accounted for a significant proportion of Gram-negative BSI.
- Multiresistant P. aeruginosa (MR P. aeruginosa) BSI showed a 30-day mortality of 36.4%.
- Active hematological disease and P. aeruginosa BSI were independently associated with increased mortality. Empiric therapy including an active antibiotic against MR P. aeruginosa significantly reduced mortality (83.3% vs. 18.8%).
Conclusions:
- The emergence of P. aeruginosa BSI, especially multiresistant strains, increases mortality in hematological patients.
- Active hematological disease is a key factor in mortality risk.
- Revising empiric antibiotic strategies for neutropenic fever is crucial to improve outcomes.
More Related Videos
10:26P. aeruginosa Infected 3D Co-Culture of Bronchial Epithelial Cells and Macrophages at Air-Liquid Interface for Preclinical Evaluation of Anti-Infectives
Published on: June 15, 2020
07:46Use of Artificial Sputum Medium to Test Antibiotic Efficacy Against Pseudomonas aeruginosa in Conditions More Relevant to the Cystic Fibrosis Lung
Published on: June 5, 2012
Related Concept Videos
01:29Pneumonia I: Introduction
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:30Pneumonia III: Complications and Assessment
01:14Atypical Pneumonia
01:25Transmission-based Precautions II: Airborne and Protective Environment
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies. Common...