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Pseudomonas bacteremia. Review of 108 cases
Abstract:
The current circumstances associated with Pseudomonas aeruginosa bacteremia are reviewed in 108 episodes to assess the impact of new antimicrobial drugs on this infection. Since 1961, Pseudomonas bacteremia has apparently become more frequent with proportional increases in middle-aged patients. The respiratory tract has become the major source of infection. Clinical features are not characteristic, but infected patients are almost uniformly severely ill before blood stream invasion occurs. The use of gentamicin, carbenicillin and colistin has not changed the outcome of Pseudomonas bacteremia. Although better than no antimicrobial treatment, these drugs cannot be shown to be superior to any other available antibiotics. A reassessment is needed to evaluate the relationship between the in vitro action and the effectiveness of antibiotics in the treatment of Pseudomonas infection and the use of gentamicin, carbenicillin and colistin in these bacteremias. In view of the poor results with antibiotics, investigation into immunologic prophylaxis and therapy is needed. At the present time, control of the patients' underlying disease contributes most towards assuring survival with Pseudomonas bacteremia.
Insights
New antimicrobial drugs have not improved outcomes for Pseudomonas aeruginosa bacteremia. Controlling underlying patient conditions remains the most effective strategy for survival against this bloodstream infection.
Area of Science:
- Infectious Diseases
- Microbiology
- Pharmacology
Background:
- Pseudomonas aeruginosa bacteremia has increased since 1961, particularly in middle-aged patients.
- The respiratory tract is now the primary source of infection.
- Patients are typically severely ill before developing bacteremia.
Purpose of the Study:
- To review 108 episodes of Pseudomonas aeruginosa bacteremia.
- To assess the impact of new antimicrobial drugs on infection outcomes.
- To re-evaluate antibiotic effectiveness against Pseudomonas infections.
Main Methods:
- Retrospective review of 108 Pseudomonas aeruginosa bacteremia cases.
- Analysis of clinical features and infection sources.
- Evaluation of antimicrobial drug efficacy, including gentamicin, carbenicillin, and colistin.
Main Results:
- The incidence of Pseudomonas bacteremia has increased, with a rise in middle-aged patients.
- Respiratory tract infections are the predominant source.
- Newer antibiotics like gentamicin, carbenicillin, and colistin have not improved patient outcomes.
Conclusions:
- Current antimicrobial therapies show limited effectiveness in treating Pseudomonas aeruginosa bacteremia.
- Further research is needed to correlate in vitro antibiotic activity with clinical outcomes.
- Immunologic prophylaxis and therapy warrant investigation.
- Management of underlying patient conditions is crucial for survival.