Pseudomonas Aeruginosa Bacteraemia in Two UK District Hospitals

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Epidemiology

Background:

• Pseudomonas aeruginosa bacteraemia presents significant patient morbidity and mortality.
• Understanding the epidemiology of P. aeruginosa bacteraemia is crucial for developing effective prevention strategies.
• Local antibiotic guidelines aim to standardize and optimize treatment for bacteraemia episodes.

Purpose of the Study:

• To investigate the epidemiology of P. aeruginosa bacteraemia in two UK district hospitals.
• To evaluate the efficacy and adherence to existing local antibiotic guidelines.
• To identify key risk factors and inform future prevention and treatment strategies.

Main Methods:

• Retrospective analysis of 86 P. aeruginosa bacteraemia episodes in 85 patients over a 3-year period.
• Data collection included patient demographics, risk factors, and treatment received.
• Comparison of prescribed antibiotic therapy against established local hospital antibiotic guidelines.

Main Results:

• A year-on-year increase in P. aeruginosa bacteraemias was observed, with a rise in community-onset cases.
• Significant risk factors identified include urinary catheterisation, anaemia, renal disease, malignancy, and diabetes.
• While guidelines were adequate for 92.8% of episodes, only 73.8% of patients received appropriate therapy.
• Non-compliance with guidelines stemmed primarily from reluctance to use gentamicin due to nephrotoxicity concerns.

Conclusions:

• Pseudomonas aeruginosa is a significant pathogen in patients presenting with sepsis symptoms.
• Current antibiotic guidelines require revision to address concerns regarding gentamicin use.
• Improved urinary catheter care strategies are necessary in both hospital and community settings.