Epidemiology and prognosis of Pseudomonas aeruginosa bacteremia in a tertiary care center.

Objective: To describe the epidemiology and prognosis of P. aeruginosa bloodstream infections in a tertiary-care center.

Methods: Retrospective analysis. Methods: Tertiary-care teaching hospital in Mexico City. Methods: All cases of P. aeruginosa bacteremia diagnosed from 1981 to 1994. Methods: Relevant demographic, clinical and therapeutic variables were analyzed.

Results: A total of 153 bacteremias were found between 1981 and 1994, with a mean prevalence of 4.1 episodes per 1000 hospital discharges. Twenty-five percent of the infections derived from the biliary tract, and the most frequent underlying diseases were hematologic malignancies. The overall crude mortality was 46% (70/153) whereas mortality in the nosocomially-acquired episodes was 47% (58/124). Mortality within the first 72 h was 24% (37/153). A multivariate analysis showed six risk factors associated with a fatal outcome: age > or = 40 years, shock, mechanical ventilation, prior use of antibiotics, splenectomy and inappropriate selection of antibiotics.

Conclusions: The identification of risk factors, and therefore a prompt instauration of specific antibiotic therapy, improved the prognosis of these severely ill patients.