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. 2020 Oct 7;20(1):729.
doi: 10.1186/s12879-020-05437-1.

Pseudomonas aeruginosa bloodstream infection at a tertiary referral hospital for children

Joycelyn Assimeng Dame  1 , Natalie Beylis  2 , James Nuttall  3 , Brian Eley  3
Affiliations

Pseudomonas aeruginosa bloodstream infection at a tertiary referral hospital for children

Joycelyn Assimeng Dame et al. BMC Infect Dis. .

Abstract

Background: This study describes the disease burden, clinical characteristics, antibiotic management, impact of multidrug resistance and outcome of Pseudomonas aeruginosa bloodstream infection (PABSI) among children admitted to a tertiary referral hospital for children in Cape Town, South Africa.

Methods: A retrospective descriptive study was conducted at a paediatric referral hospital in Cape Town, South Africa. Demographic and clinical details, antibiotic management and patient outcome information were extracted from medical and laboratory records. Antibiotic susceptibility results of identified organisms were obtained from the National Health Laboratory Service database.

Results: The incidence risk of PABSI was 5.4 (95% CI: 4.34-6.54) PABSI episodes / 10,000 hospital admissions and the most common presenting feature was respiratory distress, 34/91 (37.4%). Overall, 69/91 (75.8%) of the PA isolates were susceptible to all antipseudomonal antibiotic classes evaluated. Fifty (54.9%) of the PABSI episodes were treated with appropriate empiric antibiotic therapy. The mortality rate was 24.2% and in multivariable analysis, empiric antibiotic therapy to which PA isolates were not susceptible, infections present on admission, and not being in the intensive care unit at the time that PABSI was diagnosed were significantly associated with 14-day mortality.

Conclusions: PABSI caused appreciable mortality, however, appropriate empiric antibiotic therapy was associated with reduced 14-day mortality.

Keywords: Children; Pseudomonas aeruginosa bloodstream infection; Sub-Saharan Africa.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Selection of Pseudomonas aeruginosa bloodstream infection episodes for data analysis. CDW, Central Data warehouse; PABSI, Pseudomonas aeruginosa bloodstream infection; RCWMCH, Red Cross War Memorial Children’s Hospital
Fig. 2
Fig. 2
Annual incidence risk per 10,000 hospital admissions. HAI, healthcare-associated infection; IPOA, infection present on admission
Fig. 3
Fig. 3
Annual antibiotic susceptibility profile of Pseudomonas aeruginosa isolates by antipseudomonal antibiotic susceptibility category, 2009–2017. Multidrug-resistant (MDR), non-susceptible to at least one agent in three or more antipseudomonal antibiotic categories; extensively drug-resistant (XDR), non-susceptible to at least one agent in all but two or fewer antipseudomonal antibiotic categories
See this image and copyright information in PMC

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