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Trends in bacteraemia due to Pseudomonas aeruginosa: comparison between oncohaematologic and non-oncohaematologic patients

Abstract number: 1733_213

Loza E., Lopez-Martin J., Lopez-Jimenez J., Canton R., Baquero F., Moreno S., Fortun J., Martin-Davila P., Ayala G., Fernandez-Cofrades E.

Objectives: To review epidemiological aspects of P. aeruginosa. (PA) bacteraemia, prognostic factors, and changes in their antimicrobial (Ab) susceptibility patterns in oncohaematologic (OH) and non-OH patients.

Methods: A retrospective review during a 10-year period (1996–2005) in our institution was performed including all episodes with at least one positive blood culture yielding PA from patients with diagnosis of active cancer, receiving or not chemotherapy at bacteriemic episode (OH group) and non-OH patients. Clinical, microbiological and epidemiological data were obtained and compared. Bacteraemia was considered nosocomial if the diagnosis was done ≥72 h after hospital admission and no evidence of bacteraemia was present at the time of admission. Also patients diagnosed after discharge within 60 days of a previous hospital admission.

Results: From Jan-96 to Dec-05 a total of 354 episodes of PA bacteraemia were identified, 342 for full-analysis (125 episodes occurring in OH patients). Total PA bacteraemia episodes per year remains stable but time trends analysis showed an increased rate of episodes occurring in OH patients. Mean ages were similar in both groups (61 vs 60 years). Mean time from hospital admission to bacteraemia was 16 days in OH vs. 24 days in non-OH (p = 0.04). Bacteraemia was considered nosocomial-acquired in 86% of OH and 83% of non-OH groups. Patients staying at ICU during bacteraemia were 4% in OH and 45.5% in non-OH patients (p < 0.001). Ab susceptibility profiles are shown in the table.

No significant differences were found when compared Ab susceptibilities between both groups, but a general decrease in susceptibility was observed. In 2005, 10% of isolates were multidrug-resistant (≥3 Ab groups) in OH and non-OH patients Mortality at 30 days after bacteraemia was similar in both groups (38% vs 31%, p = NS).

Ab susceptibility profilesa

  1996199719981999200020012002200320042005
% CAZOH000010009610
Non-OH1211004.511.511.518125  
% FQOH00000012.593334.5
Non-OH4110014419183235  
% AGOH01790200092831
Non-OH49004.50801632.5  
% CarbapenemsOH000001112.541114
Non-OH4110091938.5182815  
% ColistinOH0000000003
4000000080   
% Non-resistanceOH1008382100808987.5745655
Non-OH765700827350594455  
% R to >=3 groupsOH00000000610
Non-OH03004.5011.54.51210  
aNo. of isolates: 125 OH, 217 Non-OH.

Conclusions: Bacteraemia due to PA increased in OH patients. Analysis of Ab susceptibility patterns showed an increase in resistance to ciprofloxacin, aminoglycosides and, to a lesser degree, to carbapenems in both studied groups. Mortality remains high in both groups.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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