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

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2006-07-01
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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.
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Journal of Infection. London: W B Saunders Co Ltd, v. 53, n. 1, p. 30-35, 2006.