RT Journal Article
T1 Pseudomonas aeruginosa Community-Onset Bloodstream Infections: Characterization, Diagnostic Predictors, and Predictive Score Development-Results from the PRO-BAC Cohort.
A1 Martínez Pérez-Crespo, Pedro María
A1 Rojas, Álvaro
A1 Lanz-García, Joaquín Felipe
A1 Retamar-Gentil, Pilar
A1 Reguera-Iglesias, José María
A1 Lima-Rodríguez, Olalla
A1 Del Arco Jiménez, Alfonso
A1 Fernández Suárez, Jonathan
A1 Jover-Saenz, Alfredo
A1 Goikoetxea Aguirre, Josune
A1 León Jiménez, Eva
A1 Cantón-Bulnes, María Luisa
A1 Ortega Lafont, Pilar
A1 Armiñanzas Castillo, Carlos
A1 Sevilla Blanco, Juan
A1 Cuquet Pedragosa, Jordi
A1 Boix-Palop, Lucía
A1 Becerril Carral, Berta
A1 Bahamonde-Carrasco, Alberto
A1 Marrodan Ciordia, Teresa
A1 Natera Kindelán, Clara
A1 Reche Molina, Isabel María
A1 Herrero Rodríguez, Carmen
A1 Pérez Camacho, Inés
A1 Vinuesa García, David
A1 Galán-Sánchez, Fátima
A1 Smithson Amat, Alejandro
A1 Merino de Lucas, Esperanza
A1 Sánchez-Porto, Antonio
A1 Guzmán García, Marcos
A1 López-Hernández, Inmaculada
A1 Rodríguez-Baño, Jesús
A1 López-Cortés, Luis Eduardo
A1 On Behalf Of The Probac Reipi/Geih-Seimc/Saei Group, 
K1 Pseudomonas aeruginosa
K1 bacteraemia
K1 bloodstream infection
K1 community-onset
K1 epidemiology
AB Community-onset bloodstream infections (CO-BSI) caused by gram-negative bacilli are common and associated with significant mortality; those caused by Pseudomonas aeruginosa are associated with worse prognosis and higher rates of inadequateempirical antibiotic treatment. The aims of this study were to describe the characteristics of patients with CO-BSI caused by P. aeruginosa, to identify predictors, and to develop a predictive score for P. aeruginosa CO-BSI. Materials/methods: PROBAC is a prospective cohort including patients >14 years with BSI from 26 Spanish hospitals between October 2016 and May 2017. Patients with monomicrobial P. aeruginosa CO-BSI and monomicrobial Enterobacterales CO-BSI were included. Variables of interest were collected. Independent predictors of Pseudomonas aeruginosa CO-BSI were identified by logistic regression and a prediction score was developed. Results: A total of 78patients with P. aeruginosa CO-BSI and 2572 with Enterobacterales CO-BSI were included. Patients with P. aeruginosa had a median age of 70 years (IQR 60−79), 68.8% were male, median Charlson score was 5 (IQR 3−7), and 30-daymortality was 18.5%. Multivariate analysis identified the following predictors of CO-BSI-PA [adjusted OR (95% CI)]: male gender [1.89 (1.14−3.12)], haematological malignancy [2.45 (1.20−4.99)], obstructive uropathy [2.86 (1.13−3.02)], source of infection other than urinary tract, biliary tract or intra-abdominal [6.69 (4.10−10.92)] and healthcare-associated BSI [1.85 (1.13−3.02)]. Anindex predictive of CO-BSI-PA was developed; scores ≥ 3.5 showed a negative predictive value of 89% and an area under the receiver operator curve (ROC) of 0.66. Conclusions: We did not find a good predictive score of P. aeruginosa CO-BSI due to its relatively low incidence in the overall population. Our model includes variables that are easy to collect in real clinical practice and could be useful to detect patients with very low risk of P. aeruginosa CO-BSI.
SN 2079-6382
YR 2022
FD 2022-05-24
LK http://hdl.handle.net/10668/20761
UL http://hdl.handle.net/10668/20761
LA en
DS RISalud
RD Apr 6, 2025