[Clinical features and prognosis of Pseudomonas aeruginosa infection in patients with hematologic malignancies]

Zhonghua Xue Ye Xue Za Zhi. 2024 Nov 14;45(11):1028-1034. doi: 10.3760/cma.j.cn121090-20240824-00319.
[Article in Chinese]

Abstract

Objective: This study aimed to investigate the clinical features and prognosis of Pseudomonas aeruginosa infection in patients with hematologic malignancies. Methods: This study retrospectively analyzed the clinical data of 197 patients with hematologic malignancies complicated with P. aeruginosa infection who were hospitalized in the Department of Hematology from January 01, 2019, to December 31, 2021. Patients were categorized into a susceptible group (CSPA infection group) and a drug-resistant group (CRPA infection group) based on their sensitivity to carbapenems, comparing the differences in clinical features between the two groups, and analyzing the risk factors and prognosis of CRPA infection. Results: Logistic regression analysis revealed that hospitalization days of >50 days (P=0.010, OR=3.581, 95% CI 1.356-9.457), history of antibiotic exposure (P=0.008, OR=4.394, 95% CI 1.358-6.238), more than two courses of chemotherapy before infection (P=0.006, OR=2.911, 95% CI 1.358-6.238) were independent risk factors for developing CRPA. The mortality rates were 12.8% (18/140) and 28.1% (16/57) in patients with CRPA and CSPA, respectively (P=0.010). Logistic regression analysis revealed that bloodstream infection (BSI) (P=0.039, OR=5.286, 95% CI 1.091-25.621) was an independent risk factor for hematologic malignancies and death from CRPA infection. Conclusion: Hospitalization for >50 days, history of antibiotic exposure, and >2 courses of chemotherapy before infection were independent risk factors for CRPA infection. Hematologic malignancies with CRPA infection had a high mortality rate, of which BSI was an independent risk factor for 30-day mortality from hematologic malignancies with CRPA infection.

目的: 探讨恶性血液病患者发生铜绿假单胞菌感染的临床特征及预后影响因素。 方法: 回顾性分析2019年1月1日至2021年12月31日期间在福建医科大学附属协和医院血液科住院的197例合并铜绿假单胞菌感染的恶性血液病患者的临床资料。根据对碳青霉烯类药物的敏感性分为敏感组(CSPA感染组)和耐药组(CRPA感染组),比较两组患者临床特征的差异,分析容易发生CRPA感染的危险因素及预后情况。 结果: Logistic回归多因素分析显示住院天数>50 d(P=0.010,OR=3.581,95%CI 1.356~9.457)、抗生素暴露史(P=0.008,OR=4.394,95%CI 1.358~6.238)、感染前化疗次数>2次(P=0.006,OR=2.911,95%CI 1.358~6.238)为发生CRPA感染的独立危险因素。CSPA感染组和CRPA感染组30 d全因死亡率分别为12.8%(18/140)、28.1%(16/57)(P=0.010)。Logistic回归多因素分析显示血流感染(P=0.039,OR=5.286,95%CI 1.091~25.621)是恶性血液病伴CRPA感染死亡的独立危险因素。 结论: 住院天数>50 d、抗生素暴露史、感染前化疗次数>2次为恶性血液病患者发生CRPA感染的独立风险因素。血液病患者CRPA感染后死亡率高,血流感染为其主要死亡原因。.

Keywords: Bloodstream infection; Carbapenem-resistant Pseudomonas aeruginosa; Carbapenem-sensitive Pseudomonas aeruginosa; Pseudomonas aeruginosa infection.

Publication types

  • English Abstract

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Female
  • Hematologic Neoplasms* / complications
  • Hematologic Neoplasms* / microbiology
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Pseudomonas Infections*
  • Pseudomonas aeruginosa* / isolation & purification
  • Retrospective Studies
  • Risk Factors

Substances

  • Anti-Bacterial Agents