Table 2. Clinical characteristics, treatment, and outcomes in patients with P. aeruginosa bacteremia.
| Characteristics | Total (n = 295) | CRPA (n = 73) | Non-CRPA (n = 222) | P | MDRPA (n = 106) | Non-MDRPA (n = 189) | P | XDRPA (n = 47) | Non- XDRPA (n = 248) | P | |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, yrs | 68 (60–76) | 72 (60–77) | 68 (60–75) | 0.078 | 72 (61–77) | 67 (57–75) | 0.041 | 73 (65–79) | 68 (58–75) | 0.005 | |
| Male sex | 197 (66.8) | 53 (72.6) | 144 (64.9) | 0.223 | 73 (68.9) | 124 (65.6) | 0.568 | 34 (72.3) | 163 (65.7) | 0.377 | |
| Underlying diseases or conditions | |||||||||||
| Cardiovascular disease | 30 (10.2) | 10 (13.7) | 20 (9.0) | 0.250 | 10 (9.4) | 20 (10.6) | 0.754 | 6 (12.8) | 24 (9.7) | 0.597 | |
| Cerebrovascular accident | 40 (13.6) | 19 (26.0) | 21 (9.5) | < 0.001 | 21 (19.8) | 19 (10.1) | 0.019 | 13 (27.7) | 27 (10.9) | 0.002 | |
| Chronic kidney disease | 24 (8.1) | 6 (8.2) | 18 (8.1) | 0.976 | 8 (7.5) | 16 (8.5) | 0.782 | 6 (12.8) | 18 (7.3) | 0.240 | |
| COPD or chronic lung disease | 7 (2.4) | 2 (2.7) | 5 (2.3) | 0.812 | 2 (1.9) | 5 (2.6) | 1.000 | 2 (4.3) | 5 (2.0) | 0.309 | |
| Dementia | 14 (4.7) | 3 (4.1) | 11 (5.0) | 1.000 | 5 (4.7) | 9 (4.8) | 0.986 | 4 (8.5) | 10 (4.0) | 0.250 | |
| Diabetes | 84 (28.5) | 23 (31.5) | 61 (27.5) | 0.508 | 35 (33.0) | 49 (25.9) | 0.195 | 19 (40.4) | 65 (26.2) | 0.048 | |
| Heart failure | 14 (4.7) | 2 (2.7) | 12 (5.4) | 0.353 | 4 (3.8) | 10 (5.3) | 0.556 | 2 (4.3) | 12 (4.8) | 1.000 | |
| Hypertension | 112 (38.0) | 30 (41.1) | 82 (36.9) | 0.525 | 43 (40.6) | 69 (36.5) | 0.491 | 23 (48.9) | 89 (35.9) | 0.091 | |
| Liver disease | 12 (4.1) | 2 (2.7) | 10 (4.5) | 0.737 | 4 (3.8) | 8 (4.2) | 1.000 | 0 (0.0) | 12 (4.8) | 0.225 | |
| Solid cancer | 155 (52.5) | 30 (41.1) | 125 (56.3) | 0.024 | 47 (44.3) | 108 (57.1) | 0.035 | 15 (31.9) | 140 (56.5) | 0.002 | |
| Hematologic malignancy | 26 (8.8) | 10 (13.7) | 16 (7.2) | 0.090 | 10 (9.4) | 16 (8.5) | 0.778 | 6 (12.8) | 20 (8.1) | 0.297 | |
| Immunosuppressive therapy | 102 (34.6) | 20 (27.4) | 82 (36.9) | 0.137 | 24 (22.6) | 78 (41.3) | 0.001 | 12 (25.5) | 90 (36.3) | 0.155 | |
| Neutropenia | 54 (18.3) | 10 (13.7) | 44 (19.8) | 0.241 | 13 (12.3) | 41 (21.7) | 0.045 | 7 (14.9) | 47 (19.0) | 0.509 | |
| Transplantation | 7 (2.4) | 3 (4.1) | 4 (1.8) | 0.261 | 3 (2.8) | 4 (2.1) | 0.705 | 2 (4.3) | 5 (2.0) | 0.309 | |
| CCI score | 5 (4–8) | 5 (3–7) | 5 (4–8) | 0.181 | 5 (3–7) | 5 (4–8) | 0.118 | 5 (3–7) | 5 (4–8) | 0.167 | |
| CCI score ≥ 5 | 170 (57.6) | 37 (50.7) | 133 (59.9) | 0.166 | 56 (52.8) | 114 (60.3) | 0.212 | 24 (51.1) | 146 (58.9) | 0.321 | |
| Healthcare-associated infection | 245 (83.1) | 67 (91.8) | 178 (80.2) | 0.022 | 93 (87.7) | 152 (80.4) | 0.108 | 42 (89.4) | 203 (81.9) | 0.209 | |
| Previous surgery within 90 days | 66 (22.4) | 18 (24.7) | 48 (21.6) | 0.589 | 21 (19.8) | 45 (23.8) | 0.429 | 10 (21.3) | 56 (22.6) | 0.844 | |
| Any antibiotic exposure within 90 days | 221 (74.9) | 61 (83.6) | 160 (72.1) | 0.049 | 87 (82.1) | 134 (70.9) | 0.034 | 38 (80.9) | 183 (73.8) | 0.306 | |
| Aminoglycosides | 14 (4.7) | 8 (11.0) | 6 (2.7) | 0.004 | 9 (8.5) | 5 (2.6) | 0.023 | 6 (12.8) | 8 (3.2) | 0.013 | |
| 3rd/4th generation cephalosporins | 152 (51.5) | 44 (60.3) | 108 (48.6) | 0.085 | 64 (60.4) | 88 (46.6) | 0.023 | 26 (55.3) | 126 (50.8) | 0.570 | |
| Anti-pseudomonal penicillins | 49 (16.6) | 19 (26.0) | 30 (13.5) | 0.013 | 23 (21.7) | 26 (13.8) | 0.079 | 10 (21.3) | 39 (15.7) | 0.348 | |
| Carbapenems | 42 (14.2) | 30 (41.1) | 12 (5.4) | < 0.001 | 28 (26.4) | 14 (7.4) | < 0.001 | 15 (31.9) | 27 (10.9) | < 0.001 | |
| Fluoroquinolones | 66 (22.4) | 33 (45.2) | 33 (14.9) | < 0.001 | 36 (34.0) | 30 (15.9) | < 0.001 | 22 (46.8) | 44 (17.7) | < 0.001 | |
| Metronidazole | 46 (15.6) | 16 (21.9) | 30 (13.5) | 0.086 | 21 (19.8) | 25 (13.2) | 0.135 | 11 (23.4) | 35 (14.1) | 0.107 | |
| Clindamycin | 13 (4.4) | 8 (11.0) | 5 (2.3) | 0.004 | 7 (6.6) | 6 (3.2) | 0.236 | 5 (10.6) | 8 (3.2) | 0.039 | |
| Glycopeptides | 40 (13.6) | 27 (37.0) | 13 (5.9) | < 0.001 | 27 (25.5) | 13 (6.9) | < 0.001 | 14 (29.8) | 26 (10.5) | < 0.001 | |
| Linezolid | 8 (2.7) | 4 (5.5) | 4 (1.8) | 0.093 | 4 (3.8) | 4 (2.1) | 0.464 | 1 (2.1) | 7 (2.8) | 1.000 | |
| Tigecycline | 7 (2.4) | 5 (6.8) | 2 (0.9) | 0.004 | 5 (4.7) | 2 (1.1) | 0.102 | 1 (2.1) | 6 (2.4) | 1.000 | |
| Colistin | 7 (2.4) | 5 (6.8) | 2 (0.9) | 0.004 | 5 (4.7) | 2 (1.1) | 0.102 | 1 (2.1) | 6 (2.4) | 1.000 | |
| Colonization with MDROs | |||||||||||
| CRE | 4 (1.4) | 2 (2.7) | 2 (0.9) | 0.239 | 3 (2.8) | 1 (0.5) | 0.134 | 1 (2.1) | 3 (1.2) | 0.502 | |
| ESBL | 27 (9.4) | 10 (13.7) | 17 (7.7) | 0.120 | 10 (9.4) | 17 (9.0) | 0.900 | 4 (8.5) | 23 (9.3) | 1.000 | |
| MRAB | 16 (5.4) | 8 (11.0) | 8 (3.6) | 0.016 | 9 (8.5) | 7 (3.7) | 0.082 | 2 (4.3) | 14 (5.6) | 1.000 | |
| MRSA | 5 (1.7) | 1 (1.4) | 4 (1.8) | 1.000 | 1 (0.9) | 4 (2.1) | 0.658 | 0 (0) | 5 (2.0) | 1.000 | |
| VRE | 19 (6.4) | 13 (17.8) | 6 (2.7) | < 0.001 | 12 (11.3) | 7 (3.7) | 0.011 | 5 (10.6) | 14 (5.6) | 0.200 | |
| ICU stay | 48 (16.3) | 24 (32.9) | 24 (10.8) | < 0.001 | 24 (22.6) | 24 (12.7) | 0.026 | 12 (25.5) | 36 (14.5) | 0.061 | |
| Devices during time at risk | |||||||||||
| Central venous catheter | 107 (36.3) | 34 (46.6) | 73 (32.9) | 0.035 | 36 (34.0) | 71 (37.6) | 0.537 | 19 (40.4) | 88 (35.5) | 0.518 | |
| Ventilator | 29 (9.8) | 13 (17.8) | 16 (7.2) | 0.008 | 18 (17.0) | 11 (5.8) | 0.002 | 7 (14.9) | 22 (8.9) | 0.192 | |
| Indwelling urinary catheter | 100 (33.9) | 37 (50.7) | 63 (28.4) | < 0.001 | 51 (48.1) | 49 (25.9) | < 0.001 | 24 (51.1) | 76 (30.6) | 0.007 | |
| Shock on the first day of bacteremia | 84 (28.5) | 21 (28.8) | 63 (28.4) | 0.949 | 31 (29.2) | 53 (28.0) | 0.826 | 14 (29.8) | 70 (28.2) | 0.828 | |
| Primary site of infection | |||||||||||
| Hepato-biliary tract | 79 (26.8) | 19 (26.0) | 60 (27.0) | 0.867 | 42 (39.6) | 37 (19.6) | < 0.001 | 13 (27.7) | 66 (26.6) | 0.882 | |
| Gastrointestinal tract | 19 (6.4) | 3 (4.1) | 16 (7.2) | 0.424 | 4 (3.8) | 15 (7.9) | 0.162 | 2 (4.3) | 17 (6.9) | 0.748 | |
| Respiratory tract | 69 (23.4) | 13 (17.8) | 56 (25.2) | 0.194 | 18 (17.0) | 51 (27.0) | 0.051 | 10 (21.3) | 59 (23.8) | 0.709 | |
| Urinary tract | 50 (16.9) | 22 (30.1) | 28 (12.6) | 0.001 | 25 (23.6) | 25 (13.2) | 0.023 | 16 (34.0) | 34 (13.7) | < 0.001 | |
| Central venous catheter | 39 (13.2) | 11 (15.1) | 28 (12.6) | 0.591 | 10 (9.4) | 29 (15.3) | 0.150 | 4 (8.5) | 35 (14.1) | 0.357 | |
| Skin and soft tissue | 12 (4.1) | 2 (2.7) | 10 (4.5) | 0.508 | 3 (2.8) | 9 (4.8) | 0.547 | 1 (2.1) | 11 (4.1) | 0.698 | |
| Surgical site | 2 (0.7) | 0 (0) | 2 (0.9) | 1.000 | 0 (0.0) | 2 (1.1) | 0.538 | 0 (0.0) | 2 (0.8) | 1.000 | |
| Primary bloodstream | 25 (8.5) | 3 (4.1) | 22 (9.9) | 0.123 | 4 (3.8) | 21 (11.1) | 0.030 | 1 (2.1) | 24 (9.7) | 0.147 | |
| Polymicrobial bacteremia | 50 (16.9) | 11 (15.1) | 39 (17.6) | 0.622 | 15 (14.2) | 35 (18.5) | 0.337 | 5 (10.6) | 45 (18.1) | 0.209 | |
| Invasive drainage procedures | 62 (21.0) | 13 (17.8) | 49 (22.1) | 0.438 | 30 (28.3) | 32 (16.9) | 0.021 | 10 (21.3) | 52 (21.0) | 0.962 | |
| Active antimicrobial therapy | 244 (82.7) | 54 (74.0) | 190 (85.6) | 0.023 | 77 (72.6) | 167 (88.4) | 0.001 | 34 (72.3) | 210 (84.7) | 0.040 | |
| Concordant empirical antimicrobial therapy | 181 (61.4) | 25 (34.2) | 156 (70.3) | < 0.001 | 36 (34.0) | 145 (76.7) | < 0.001 | 15 (31.9) | 166 (66.9) | < 0.001 | |
| Single antibiotics | 151 (51.2) | 23 (31.5) | 128 (57.7) | 34 (32.1) | 117 (61.9) | 14 (29.8) | 137 (55.2) | ||||
| Combination antibiotics | 30 (10.2) | 2 (2.7) | 28 (12.6) | 2 (1.9) | 28 (14.8) | 1 (2.1) | 29 (11.7) | ||||
| Duration of active antibiotics, days | 8 (1–15) | 7 (0–14) | 8 (2–14) | 0.172 | 7 (0–14) | 8 (2–15.5) | 0.072 | 8 (0–15) | 8 (2–14.8) | 0.207 | |
| Length of hospital stay after bacteremia, days | 10 (4–18) | 12 (5–23) | 10 (5–18) | < 0.001 | 10 (5–17) | 9 (4–18) | 0.213 | 11 (5–22) | 9 (4–17.5) | 0.204 | |
| 30-day mortality | 80 (27.1) | 22 (30.1) | 58 (26.1) | 0.504 | 28 (35.0) | 52 (27.5) | 0.839 | 14 (29.8) | 66 (26.6) | 0.654 | |
Values are presented as median (interquartile range) or number (%).
CRPA = carbapenem-resistant P. aeruginosa, MDRPA = multidrug-resistant P. aeruginosa, XDRPA = extensively drug-resistant P. aeruginosa, COPD = chronic obstructive pulmonary disease, CCI = Charlson comorbidity index, MDRO = multidrug-resistant organism, CRE = carbapenem-resistant Enterobacteriaceae, ESBL = extended-spectrum beta-lactamase-producing bacteria, MRAB = multi-drug resistant Acinetobacter baumannii, MRSA = methicillin-resistant Staphylococcus aureus, VRE = vancomycin-resistant Enterococcus, ICU = intensive care unit.