Risk Factors for Mortality of Inpatients with Pseudomonas aeruginosa Bacteremia in China: Impact of Resistance Profile in the Mortality

Yulin Zhang; Yi Li; Ji Zeng; Yanzi Chang; Shouhua Han; Jiankang Zhao; Yanyan Fan; Zhujia Xiong; Xiaohui Zou; Chunlei Wang; Binbin Li; Haibo Li; Jiajing Han; Xinmeng Liu; Yudi Xia; Binghuai Lu; Bin Cao

doi:10.2147/IDR.S268744

Risk Factors for Mortality of Inpatients with Pseudomonas aeruginosa Bacteremia in China: Impact of Resistance Profile in the Mortality

Infect Drug Resist. 2020 Nov 12:13:4115-4123. doi: 10.2147/IDR.S268744. eCollection 2020.

Authors

Yulin Zhang¹, Yi Li², Ji Zeng³, Yanzi Chang⁴, Shouhua Han⁵, Jiankang Zhao¹, Yanyan Fan¹, Zhujia Xiong¹, Xiaohui Zou¹, Chunlei Wang¹, Binbin Li¹, Haibo Li¹, Jiajing Han¹, Xinmeng Liu¹, Yudi Xia¹, Binghuai Lu¹, Bin Cao^{1

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Affiliations

¹ Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, Center for Respiratory Diseases, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, Beijing 100029, People's Republic of China.
² Department of Laboratory Medicine, Henan Provincial People's Hospital, Zhengzhou, People's Republic of China.
³ Department of Laboratory Medicine, Wuhan Pu Ai Hospital of Huazhong University of Science and Technology, Wuhan, People's Republic of China.
⁴ Department of Laboratory Medicine, Ningbo Medical Center Lihuili Hospital, Ningbo, People's Republic of China.
⁵ Department of Laboratory Medicine, Weifang No.2 People's Hospital, Weifang, People's Republic of China.
⁶ Clinical Center for Pulmonary Infections, Capital Medical University, Beijing, People's Republic of China.
⁷ Tsinghua University-Peking University, Joint Center for Life Sciences, Beijing, People's Republic of China.

Abstract

Purpose: Pseudomonas aeruginosa bacteremia presents a severe challenge to hospitalized patients. However, to date, the risk factors for mortality among inpatients with P. aeruginosa bacteremia in China remain unclear.

Patients and methods: This retrospective multicenter study was performed to analyze 215 patients with culture-confirmed P. aeruginosa bacteremia in five healthcare centers in China during the years 2012-2019.

Results: Of 215 patients with P. aeruginosa bacteremia, 61 (28.4%) died during the study period. Logistic multivariable analysis revealed that cardiovascular disease (OR=3.978, P=0.001), blood transfusion (OR=5.855, P<0.001) and carbapenem-resistant P. aeruginosa (CRPA) phenotype (OR=4.485, P=0.038) constituted the independent risk factors of mortality. Furthermore, both CRPA and multidrug-resistant P. aeruginosa (MDRPA) phenotypes were found to be significantly associated with 5-day mortality (Log-rank, P<0.05).

Conclusion: This study revealed a high mortality rate amongst hospitalized patients with P. aeruginosa bacteremia, and those with cardiovascular diseases, CRPA and MDRPA phenotypes, should be highlighted and given appropriate management in China.

Keywords: Pseudomonas aeruginosa; bacteremia; mortality; risk factors.

Grants and funding

This work was supported by the National Science Fund for Distinguished Young Scholars [grant number 81425001/H0104 to C.B]; CAMS Innovation Fund for Medical Sciences [CIFMS 2018-I2M-1-003 to C.B]; National Key Research and Development Program of China [grant number 2018YFC1200102 to L.B].