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Pseudomonas aeruginosa Bloodstream Infections Presenting with Septic Shock in Neutropenic Cancer Patients: Impact of Empirical Antibiotic Therapy

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dc.contributor.authorRoyo, Cristina
dc.contributor.authorLaporte, Julia
dc.contributor.authorPeña, Marta
dc.contributor.authorRuiz, Isabel
dc.contributor.authorGarcia, Carolina
dc.contributor.authorAbdala, Edson
dc.contributor.authorOltolini, Chiara
dc.contributor.authorAkova, Murat
dc.contributor.authorMontejo, Miguel
dc.contributor.authorMikulska, Malgorzata
dc.contributor.authorMartín, Pilar
dc.contributor.authorHerrera, Fabián
dc.contributor.authorGasch, Oriol
dc.contributor.authorDrgona, Lubos
dc.contributor.authorPaz, Hugo
dc.contributor.authorBrunel, Anne
dc.contributor.authorGarcía, Estefanía
dc.contributor.authorIsler, Burcu
dc.contributor.authorKern, Winfried
dc.contributor.authorPalacios, Zaira
dc.contributor.authorMaestr de la Calle, Guillermo
dc.contributor.authorMontero, Maria
dc.contributor.authorKanj, Souha
dc.contributor.authorSipahi, Oguz
dc.contributor.authorCalik, Sebnem
dc.contributor.authorMárquez, Ignacio
dc.contributor.authorMarin, Jorge
dc.contributor.authorGomes, Marisa
dc.contributor.authorHemmatii, Philipp
dc.contributor.authorAraos Bralic, Rafael Ignacio
dc.contributor.authorPeghin, Maddalena
dc.contributor.authorDel Pozo, Jose
dc.contributor.authorYáñez, Lucrecia
dc.contributor.authorTilley, Robert
dc.contributor.authorManzur, Adriana
dc.contributor.authorNovo, Andrés
dc.contributor.authorCarratalà, Jordi
dc.contributor.authorGudiol, Carlota
dc.contributor.authorIRONIC Study Group
dc.date.accessioned2025-01-15T19:18:12Z
dc.date.available2025-01-15T19:18:12Z
dc.date.issued2024
dc.description.abstractThis large, multicenter, retrospective cohort study including onco-hematological neutropenic patients with Pseudomonas aeruginosa bloodstream infection (PABSI) found that among 1213 episodes, 411 (33%) presented with septic shock. The presence of solid tumors (33.3% vs. 20.2%, p < 0.001), a high-risk Multinational Association for Supportive Care in Cancer (MASCC) index score (92.6% vs. 57.4%; p < 0.001), pneumonia (38% vs. 19.2% p < 0.001), and infection due to multidrug-resistant P. aeruginosa (MDRPA) (33.8% vs. 21.1%, p < 0.001) were statistically significantly higher in patients with septic shock compared to those without. Patients with septic shock were more likely to receive inadequate empirical antibiotic therapy (IEAT) (21.7% vs. 16.2%, p = 0.020) and to present poorer outcomes, including a need for ICU admission (74% vs. 10.5%; p < 0.001), mechanical ventilation (49.1% vs. 5.6%; p < 0.001), and higher 7-day and 30-day case fatality rates (58.2% vs. 12%, p < 0.001, and 74% vs. 23.1%, p < 0.001, respectively). Risk factors for 30-day case fatality rate in patients with septic shock were orotracheal intubation, IEAT, infection due to MDRPA, and persistent PABSI. Therapy with granulocyte colony-stimulating factor and BSI from the urinary tract were associated with improved survival. Carbapenems were the most frequent IEAT in patients with septic shock, and the use of empirical combination therapy showed a tendency towards improved survival. Our findings emphasize the need for tailored management strategies in this high-risk population.
dc.description.versionVersión Publicada
dc.identifier.citationRoyo-Cebrecos C, Laporte-Amargós J, Peña M, Ruiz-Camps I, Garcia-Vidal C, Abdala E, Oltolini C, Akova M, Montejo M, Mikulska M, Martín-Dávila P, Herrera F, Gasch O, Drgona L, Morales HMP, Brunel AS, García E, Isler B, Kern WV, Palacios-Baena ZR, de la Calle GM, Montero MM, Kanj SS, Sipahi OR, Calik S, Márquez-Gómez I, Marin JI, Gomes MZR, Hemmatii P, Araos R, Peghin M, Del Pozo JL, Yáñez L, Tilley R, Manzur A, Novo A, Carratalà J, Gudiol C; IRONIC Study Group. Pseudomonas aeruginosa Bloodstream Infections Presenting with Septic Shock in Neutropenic Cancer Patients: Impact of Empirical Antibiotic Therapy. Microorganisms. 2024 Mar 30;12(4):705. doi: 10.3390/microorganisms12040705
dc.identifier.doihttps://doi.org/10.3390/microorganisms12040705
dc.identifier.urihttps://hdl.handle.net/11447/9659
dc.language.isoen
dc.subjectPseudomonas aeruginosa
dc.subjectBacteremia
dc.subjectBloodstream infection
dc.subjectCancer
dc.subjectNeutropenia
dc.subjectSeptic shock
dc.titlePseudomonas aeruginosa Bloodstream Infections Presenting with Septic Shock in Neutropenic Cancer Patients: Impact of Empirical Antibiotic Therapy
dc.typeArticle
dcterms.accessRightsAcceso Abierto
dcterms.sourceMicroorganisms
dspace.entity.typePublication
relation.isAuthorOfPublication69e40056-7a55-41b3-8a65-05aace0e07e3
relation.isAuthorOfPublication.latestForDiscovery69e40056-7a55-41b3-8a65-05aace0e07e3

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