English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Background  Although the proportion of  Pseudomonas aeruginosa  infections has reduced after the introduction of antibiotics with anti-pseudomonal effects,  P. aeruginosa  bacteremia still causes high mortality in immunocompromised patients. This study determined the clinical characteristics and outcomes of  P. aeruginosa  bacteremia and the antibiotic susceptibilities of strains isolated from febrile neutropenic patients.    Methods  Thirty-one febrile neutropenic children and adolescents with underlying hematologic/oncologic disorders diagnosed with  P. aeruginosa  bacteremia between 2011 and 2016 were enrolled in the study. Their medical records were retrospectively reviewed to evaluate the demographic and clinical characteristics. Antibiotic susceptibility rates of the isolated  P. aeruginosa  to eight antibiotic categories (anti-pseudomonal penicillin, anti-pseudomonal penicillin and β-lactamase inhibitor combination, anti-pseudomonal cephalosporin, monobactam, carbapenem, aminoglycoside, fluoroquinolone, and colistin) were also determined. Among the investigated factors, risk factors for mortality and infections by a multidrug-resistance (MDR) strain were determined.    Results  Thirty-six episodes of  P. aeruginosa  bacteremia were identified. The mean age of the enrolled patients was 9.5 ± 5.4 years, and 26 (72.2%) episodes occurred in boys. Acute myeloid leukemia (41.7%) and acute lymphoblastic leukemia (33.3%) were the most common underlying disorders. The 30-day mortality was 38.9%, and 36.1% of the episodes were caused by MDR strains. The deceased patients were more likely to experience breakthrough infection ( P  = 0.036) and bacteremia ( P  = 0.005) due to MDR strains when compared with the patients who survived. The survived patients more likely received appropriate empirical antibiotic therapy ( P  = 0.024) and anti-pseudomonal β-lactam and aminoglycoside combination therapy ( P  = 0.039) compared with the deceased patients. The antibiotic susceptibility rates of the isolated  P. aeruginosa  strains were as follows: piperacillin/tazobactam, 67.6%; meropenem, 72.2%; and amikacin, 100%.    Conclusions  Mortality due to  P. aeruginosa  bacteremia remained at 38.9% in this study, and more than one-third of the isolated strains were MDR. In this context, empirical antibiotic combination therapy to expand the antibiotic spectrum may be a strategy to reduce mortality due to  P. aeruginosa  bacteremia in febrile neutropenic patients.

bmc infectious diseases

Clinical characteristics and outcomes of Pseudomonas aeruginosa bacteremia in febrile neutropenic children and adolescents with the impact of antibiotic resistance: a retrospective study