TABLE 2.
Baseline and clinical characteristics of neutropenic cancer patients with Pseudomonas aeruginosa bloodstream infectiona
| Characteristic | Value for patients with: |
P value | ||
|---|---|---|---|---|
| Non-MDR P. aeruginosa infection (n = 908) | MDR P. aeruginosa (n = 309) | Study population (n = 1,217) | ||
| Mean (SD) age (yr) | 58.9 (16.2) | 54.4 (15.5) | 57.8 (16.2) | <0.001 |
| No. (%) of male patients | 577 (63.5) | 174 (56.3) | 751 (61.7) | 0.028 |
| No. (%) of patients with: | ||||
| Hematological disease | 641 (70.6) | 276 (89.3) | 917 (75.3) | <0.001b |
| Acute leukemia/myelodysplastic syndrome | 287 (31.6) | 164 (53) | 451 (37) | 0.001 |
| Lymphoma | 235 (25.8) | 71 (22.9) | 306 (25.1) | 0.336 |
| Multiple myeloma/Waldenström disease | 59 (6.4) | 15 (4.8) | 74 (6) | |
| Other | 60 (6.6) | 26 (8.4) | 46 (3.7) | |
| HSCT | 182 (26.6) | 108 (35.0) | 290 (23.8) | |
| Allogeneic HSCT | 97 (10.6) | 80 (25.8) | 177 (14.5) | |
| Autologous HSCT | 85 (9.3) | 28 (9) | 113 (9.2) | |
| GVHD | 49 (5.3) | 29 (9.3) | 78 (6.4) | |
| Solid tumor | 267 (29.4) | 33 (10.6) | 300 (24.6) | <0.001b |
| Lung cancer | 79 (8.7) | 10 (3.2) | 89 (7.3) | |
| Lower gastrointestinal tract tumor | 28 (3) | 2 (0.6) | 30 (2.4) | |
| Urinary tract cancer | 24 (2.6) | 5 (15.1) | 29 (2.3) | |
| Breast cancer | 28 (3) | 0 | 28 (2.3) | |
| Head and neck tumor | 22 (2.4) | 4 (0.3) | 26 (2.1) | |
| Other | 86 (9.4) | 12 (3.8) | 98 (8.05) | |
| Comorbidities | 453 (52.1) | 133 (45.7) | 586 (50.5) | 0.067 |
| Diabetes mellitus | 75 (8.2) | 11 (3.5) | 86 (7) | 0.009 |
| Chronic heart disease | 106 (11.6) | 44 (14.2) | 150 (12.3) | 0.236 |
| Chronic obstructive pulmonary disease | 79 (8.7) | 21 (6.7) | 100 (8.2) | 0.387 |
| Chronic liver disease | 25 (2.7) | 11 (3.5) | 36 (2.9) | 0.566 |
| Chronic renal disease | 26 (2.8) | 6 (1.9) | 32 (2.6) | 0.528 |
| Profound neutropenia (<0.1 × 109/liter) | 526 (59.7) | 202 (66.9) | 728 (61.5) | 0.032 |
| High-risk MASCC index score (<21 points) | 551 (67.2) | 213 (74.7) | 764 (69.1) | <0.001 |
| Grade III-IV mucositis | 111 (12.4) | 58 (19.1) | 169 (14.1) | 0.005 |
| Previous corticosteroid therapy (within 1 mo) | 456 (51.3) | 176 (58.1) | 632 (53) | 0.048 |
| Prior fluoroquinolone prophylaxis (within 1 mo) | 98 (10.9) | 97 (31.7) | 195 (16.2) | <0.001 |
| Prior antibiotic therapy (within 1 mo) | 414 (46.5) | 251 (81.8) | 665 (55.6) | <0.001 |
| Prior piperacillin-tazobactam therapy (within 1 mo) | 98 (10.8) | 101 (32.7) | 199 (16.4) | <0.001 |
| Prior antipseudomonal carbapenem therapy (within 1 mo) | 98 (10.8) | 103 (33.3) | 201 (16.5) | <0.001 |
| Prior antipseudomonal cephalosporin therapy (within 1 mo) | 72 (7.9) | 26 (8.4) | 98 (8.1) | 0.80 |
| Prior/current ICU admission | 78 (8.6) | 49 (15.9) | 127 (10.5) | 0.001 |
| Previous hospitalization (within 3 mo) | 553 (61.5) | 191 (62.6) | 744 (61.8) | 0.782 |
| Nosocomial acquisition | 177 (19.5) | 40 (12.9) | 694 (57.0%) | <0.001 |
| Urinary catheter | 122 (13.8) | 84 (28.1) | 206 (17.4) | <0.001 |
| Intravascular catheter | 626 (68.9) | 282 (91.6) | 908 (74.7) | <0.001 |
| Central venous catheter | 452 (49.7) | 164 (53) | 692 (56.8) | |
| Axillary temp of ≥38°C | 797 (88.6) | 285 (92.5) | 1,082 (88.9) | 0.062 |
| Septic shock at presentation | 271 (29.9) | 140 (45.5) | 411 (33.9) | <0.001 |
| Ecthyma gangrenosum | 33 (3.7) | 18 (5.9) | 51 (4.2) | 0.135 |
| Polymicrobial bloodstream infection | 177 (19.5) | 40 (12.9) | 217 (17.8) | 0.012 |
| High-risk bloodstream infection | 420 (52.2) | 141 (48.5) | 561 (51.2) | 0.308 |
| Source of bloodstream infection | ||||
| Endogenous source | 351 (38.7) | 104 (33.7) | 455 (37.4) | 0.022 |
| Pneumonia | 226 (24.9) | 85 (27.5) | 311 (25.6) | |
| Intravascular catheter infection | 74 (8.2) | 38 (12.3) | 112 (9.2) | |
| Neutropenic enterocolitis | 60 (6.6) | 11 (3.5) | 71 (5.8) | |
| Skin and soft tissue infection | 46 (5.1) | 24 (7.7) | 70 (5.7) | |
| Other abdominal | 50 (5.5) | 8 (2.5) | 58 (4.7) | |
| Urinary tract infection | 37 (4.1) | 14 (4.5) | 51 (4.1) | |
| Perianal abscess | 26 (2.8) | 8 (2.5) | 34 (2.8) | |
| Unknown | 11 (1.2) | 5 (1.6) | 16 (1.3) | |
| Otherc | 27 (3.0) | 12 (3.9) | 39 (3.2) | |
a
MDR, multidrug resistant; HSCT, hematopoietic stem cell transplant; GVHD, graft-versus-host disease; MASCC, Multinational Association for Supportive Care in Cancer; ICU, intensive care unit.
b
Comparison of solid tumor versus hematological disease.
c
Other consists of mucositis, n = 24; odontogenic, n = 9; sinusitis, n = 4; otitis, n = 2.