Systemic inflammatory response syndrome in adult patients with nosocomial bloodstream infection due to Pseudomonas aeruginosa

Systemic inflammatory response syndrome in adult patients with nosocomial bloodstream infection due to Pseudomonas aeruginosa

Author Marra, Alexandre R. Google Scholar
Bar, Katharine Google Scholar
Bearman, Gonzalo M. L. Google Scholar
Wenzel, Richard P. Google Scholar
Edmond, Michael B. Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Virginia Commonwealth Univ
Abstract Objectives: To evaluate relationships between the inflammatory response, clinical. course, and outcome of nosocomial. BSI due to Pseudomonas aeruginosa.Methods: We performed a historical cohort study on 77 adults with P. aeruginosa (Pa) nBSI to define the associated systemic inflammatory response syndrome (SIRS). We examined SIRS scores 2 days prior through 14 days after the first positive blood culture. Imipenem resistant-IRPa (n=20) and susceptible infections-ISPa (n=57) were compared. Variables significant in univariate analysis were entered into a logistic regression model.Results: Seventy-four percent of BSI were ISPa and 26.0% by IRPa. Septic shock occurred in 39.0%. Crude mortatity was 48.1%. There was no difference in APACHE II (AP2) scores on days -2, -1 and 0 between the ISPa and IRPa groups. Multivariate analysis revealed that AP2 >= 20 at BSI onset (P<0.001) and hematologic failure (P= 0.001) independently predicted death.Conclusions: in patients with P. aeruginosa nBSI, the incidence of septic shock and organ failure is high; patients with IRPa BSI are not more acutely M prior to infection than those with ISPa BSI and outcome is not significantly different; AP2 20 at BSI onset and the development of hematologic failure are independent predictors of death. (C) 2005 the British Infection Society. Published by Elsevier B.V. All rights reserved.
Keywords Pseudomonas aeruginosa
systemic inflammatory response
bloodstream infection
imipenem resistance
Language English
Date 2006-07-01
Published in Journal of Infection. London: W B Saunders Co Ltd, v. 53, n. 1, p. 30-35, 2006.
ISSN 0163-4453 (Sherpa/Romeo, impact factor)
Publisher W B Saunders Co Ltd
Extent 30-35
Origin http://dx.doi.org/10.1016/j.jinf.2005.08.032
Access rights Closed access
Type Article
Web of Science ID WOS:000239256200007
URI http://repositorio.unifesp.br/handle/11600/29005

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