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. 2025 Feb;53(1):117-124.
doi: 10.1007/s15010-024-02326-6. Epub 2024 Jun 20.

Predictors of mortality of Pseudomonas aeruginosa bacteraemia and the role of infectious diseases consultation and source control; a retrospective cohort study

Matthaios Papadimitriou-Olivgeris  1   2   3 , Laurence Senn  4   5 , Damien Jacot  6 , Benoit Guery  4
Affiliations

Predictors of mortality of Pseudomonas aeruginosa bacteraemia and the role of infectious diseases consultation and source control; a retrospective cohort study

Matthaios Papadimitriou-Olivgeris et al. Infection. 2025 Feb.

Abstract

Purpose: To determine predictors of mortality among patients with Pseudomonas aeruginosa bacteraemia.

Methods: Retrospective study.

Setting: This study conducted at the Lausanne University Hospital, Switzerland included adult patients with P. aeruginosa bacteraemia from 2015 to 2021.

Results: During the study period, 278 episodes of P. aeruginosa bacteraemia were included. Twenty (7%) isolates were multidrug-resistant. The most common type of infection was low respiratory tract infection (58 episodes; 21%). Sepsis was present in the majority of episodes (152; 55%). Infectious diseases consultation within 48 h of bacteraemia onset was performed in 203 (73%) episodes. Appropriate antimicrobial treatment was administered within 48 h in 257 (92%) episodes. For most episodes (145; 52%), source control was considered necessary, with 93 (64%) of them undergoing such interventions within 48 h. The 14-day mortality was 15% (42 episodes). The Cox multivariable regression model showed that 14-day mortality was associated with sepsis (P 0.002; aHR 6.58, CI 1.95-22.16), and lower respiratory tract infection (P < 0.001; aHR 4.63, CI 1.78-12.06). Conversely, interventions performed within 48 h of bacteraemia onset, such as infectious diseases consultation (P 0.036; HR 0.51, CI 0.27-0.96), and source control (P 0.009; aHR 0.17, CI 0.47-0.64) were associated with improved outcome.

Conclusion: Our findings underscore the pivotal role of early infectious diseases consultation in recommending source control interventions and guiding antimicrobial treatment for patients with P. aeruginosa bacteraemia.

Keywords: Pseudomonas aeruginosa; Infectious diseases consultation; Multidrug resistance; Sepsis; Source control.

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Conflict of interest statement

Declarations. Statements and Declarations: A part of this work was presented at the 34th European Congress of Clinical Microbiology and Infectious Diseases on 27–30 April 2024 in Barcelona, Spain. Ethics approval: The study adhered to the Declaration of Helsinki and was approved by the ethics committee of the Canton of Vaud (CER-VD 2021–02516). Consent to participate: Due to the retrospective nature of the study, the ethic committee waived the need of informed consent to participate. However, patients were excluded if they had previously refused to permit the use of their data for research purposes. Consent to publish: Due to the retrospective nature of the study, the ethic committee waived the need of informed consent to publish. However, patients were excluded if they had previously refused to permit the use of their data for research purposes. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of patients’ inclusion
Fig. 2
Fig. 2
Kaplan–Meier curves of the survival probability curves for episodes with P. aeruginosa bacteraemia categorized by the requirement for and execution of source control within 48 h. Comparison of episodes where source control was performed versus those where it was indicated but not performed: Log-rank test, P 0.004. Comparison of episodes where source control was performed versus those where source control was not warranted: Log-rank test, P < 0.001. Comparison of episodes where source control was not performed versus those where source control was not warranted: Log-rank test, P 0.267
See this image and copyright information in PMC

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