Pseudomonas aeruginosa bloodstream infections presenting with septic shock in neutropenic cancer patients: Impact of empirical antibiotic therapy
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- dc.contributor.author Royo-Cebrecos, Cristina
- dc.contributor.author Montero, Maria Milagro
- dc.contributor.author IRONIC study group
- dc.date.accessioned 2025-07-04T06:26:58Z
- dc.date.available 2025-07-04T06:26:58Z
- dc.date.issued 2024
- dc.description.abstract This 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.format.mimetype application/pdf
- dc.identifier.citation Royo-Cebrecos C, Laporte-Amargós J, Peña M, Ruiz-Camps I, Garcia-Vidal C, Abdala E, et al. 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.doi http://dx.doi.org/10.3390/microorganisms12040705
- dc.identifier.issn 2076-2607
- dc.identifier.uri http://hdl.handle.net/10230/70834
- dc.language.iso eng
- dc.publisher MDPI
- dc.relation.ispartof Microorganisms. 2024 Mar 30;12(4):705
- dc.rights © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri http://creativecommons.org/licenses/by/4.0/
- dc.subject.keyword Pseudomonas aeruginosa
- dc.subject.keyword Bacteremia
- dc.subject.keyword Bloodstream infection
- dc.subject.keyword Cancer
- dc.subject.keyword Neutropenia
- dc.subject.keyword Septic shock
- dc.title Pseudomonas aeruginosa bloodstream infections presenting with septic shock in neutropenic cancer patients: Impact of empirical antibiotic therapy
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/publishedVersion