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Original report| Volume 3, ISSUE 2, P99-104, 1999

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Improved prognosis of Pseudomonas aeruginosca bacteremia in 127 consecutive neutropenic patients with hematologic malignancies

Open ArchiveDOI:https://doi.org/10.1016/S1201-9712(99)90017-6
Improved prognosis of Pseudomonas aeruginosca bacteremia in 127 consecutive neutropenic patients with hematologic malignancies
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      Abstract

      Objectives: Although decreasing in frequency, Pseudomonas aeruginosa bacteremia is still a major challenge for neutropenic cancer patients. In patients with hematologic malignancies, the prognosis of P. aeruginosa bacteremia is particularly poor due to the prolonged and severe neutropenia, mucosal damage, and other defects in immunity related both to the underlying disease and to the cytotoxic therapy.
      Methods: To verify the outcome of P. aeruginosa bacteremia and to try to define possible prognostic factors, the authors reviewed the medical records of 127 consecutive episodes of P. aeruginosa bacteremia observed in the hematologic unit of the Verona University School of Medicine.
      Results: Presence of pneumonia and septic shock, persistence and severity of neutropenia, delayed and inappropriate antibiotic therapy, and unresponsive underlying disease had negative impact on clinical outcome of P. aeruginosa bacteremia.
      Conclusions: With recognition of the risk factors and more careful management, the prognosis of P. aeruginosa bacteremia in neutropenic patients with hematologic malignancies has improved in recent years.

      Keywords

      References

        • Chang H.Y.
        • Rodriguez V.
        • Narboni G.
        • Bodey G.P.
        • Luna M.A.
        • Freireich E.J.
        Causes of death in adults with acute leukemia.
        Medicine. 1976; 55: 259-268
        • Estey E.H.
        • Keating M.J.
        • McCredie K.B.
        • et al.
        Causes of initial remission induction failure in acute myelogenous leukemia.
        Blood. 1982; 60: 309-325
        • Singer S.C.
        • Kaplan M.M.
        • Armstrong D.
        Bacteremia and fungemia complicating neoplastic disease. A study of 364 cases.
        Am J Med. 1977; 62: 731-742
        • McCabe W.R.
        • Jackson G.G.
        Gram-negative bacteremia: I. Etiology and ecology.
        Arch Intern Med. 1962; 110: 847-855
        • Kreger B.E.
        • Cravend D.E.
        • McCabe W.R.
        Gram-negative bacteremia: IV. Re-evaluation of clinical features and treatment in 612 patients.
        Am J Med. 1980; 68: 344-355
        • Whimbey E.
        • Kiehn T.E.
        • Brannon P.
        • Blevins A.
        • Armstrong D.
        Bacteremia and fungemia in patients with neoplastic disease.
        Am J Med. 1987; 82: 723-730
        • Bisbe J.
        • Gatell J.M.
        • Puig J.
        • et al.
        Pseudomonas aeruginosa bacteremia: univariate and multivariate analyses of factors influencing the prognosis in 133 episodes.
        Rev Infect Dis. 1988; 10: 629-635
        • Gallagher P.G.
        • Watanakunakorn C.
        Pseudomonas bacteremia in a community teaching hospital 1980–1984.
        Rev Infect Dis. 1989; 11: 846-852
        • Todeschini G.
        • Vinante F.
        • Benini F.
        • Perini A.
        • Pasini F.
        • Cetto G.L.
        Gram-negative septicemia in patients with hematologic malignancies.
        Eur J Cancer. 1984; 20: 327-331
        • Fishmann L.S.
        • Armstromg D.
        Pseudomonas aeruginosa bacteremia in patients with neoplastic disease.
        Cancer. 1972; 30: 761-773
        • Flick M.R.
        • Cluff L.E.
        Pseudomonas bacteremia. Review of 108 cases.
        Am J Med. 1976; 60: 501-508
        • Balch A.L.
        • Griffin P.E.
        Pseudomonas aeruginosa bacteremia: a clinical study of 75 patients.
        Am J Med Sci. 1977; 274: 119-129
        • Tapper M.L.
        • Armstrong D.
        Bacteremia due to Pseudomonas aeruginosa complicating neoplastic disease: a progress report.
        J Infect Dis. 1974; 130 (Suppl): S14-823
        • Young L.S.
        Gentamycin clinical use with carbenicillin and in vitro studies with recent isolates of Pseudomonas aeruginosa.
        J Infect Dis. 1971; 123 (Suppl): S202-5205
        • Schimpff S.C.
        • Greene W.H.
        • Young V.M.
        • et al.
        Pseudomonas septicemia: incidence, epidemiology, prevention, and therapy in patients with advanced cancer.
        Eur J Cancer. 1973; 9: 449-453
        • Whitecar J.P.
        • Luna M.A.
        • Bodey G.E.
        Pseudomonas bacteremia in patients with malignant diseases.
        Am J Med Sci. 1970; 130: 216-233
        • Bennet J.W.
        Nosocomial infections due to Pseudomonas.
        J Infect Dis. 1974; 130: 54-57
        • Schimpff S.C.
        • Greene W.H.
        • Young V.M.
        • Wiernik P.H.
        Significance of Pseudomonas aeruginosa in the patients with leukemia and lymphoma.
        J Infect Dis. 1974; 130 (Suppl): S24-S31
        • Bustamante C.I.
        • Wade J.C.
        • Prada G.
        • Schimpff S.C.
        Pseudomonas aeruginosa bacteremias in neutropenic cancer patients.
        in: Proceedings of the 2nd International Symposium on Infections in Immunocompromised Hosts, TorontoJune 2–6, 1984
        • Bodey G.P.
        • Jadeja L.
        • Elting L.
        Pseudomonas bacteremia: retrospective analysis of 410 episodes.
        Arch Intern Med. 1985; 145: 1621-1629
        • Kreger B.E.
        • Craven D.E.
        • Carling P.C.
        • McCabe W.R.
        Gram-negative bacteremia. III. Reassessment of etiology, epidemiology, and ecology in 612 patients.
        Am J Med. 1980; 68: 332-343
        • Schimpff S.C.
        • Satterlee W.
        • Young V.M.
        • et al.
        Empiric therapy with carbenicillin and gentamycin for febrile patients with cancer and granulocytopenia.
        N Engl J Med. 1977; 284: 1061-1065
        • Hovgaard D.
        • Skinhoj P.
        • Bangsborg J.
        • Bruun B.
        • Mork Hansen M.
        • Nissen N.I.
        Bacteremia and candidemia in hematological malignancies: clinical findings.
        Scand J Infect Dis. 1988; 20: 495-501
        • Haug J.B.
        • Harthug S.
        • Kalager T.
        • et al.
        Bloodstream infection at a Norwegian university hospital, 1974–1979 and 1988–1989: changing etiology, clinical features, and outcome.
        Clin Infect Dis. 1994; 19: 245-256
        • Cross A.
        • Allen J.
        • Burke J.
        • Ducel G.
        • Harris A.
        • John J.
        Nosocomial infections due to Pseudomonas aeruginosa: review of recent trends.
        Rev Infect Dis. 1983; 15 (Suppl): S837-S845
        • Gould I.M.
        • Wise R.
        Pseudomonas aeruginosa: clinical manifestations and management.
        Lancet. 1985; ii: 1224-1227
        • Gatell J.M.
        • Trilla A.
        • Latorre X.
        • et al.
        Nosocomial bacteremia in a large Spanish teaching hospital: analysis of factor influencing prognosis.
        Rev Infect Dis. 1988; 10: 203-210
        • Geerdes H.E.
        • Ziegler D.
        • Lode H.
        • et al.
        Septicemia in 980 patients at a university hospital in Berlin: prospective studies during four selected years between 1979 and 1989.
        Clin Infect Dis. 1992; 15: 991-1002
        • Roberts F.J.
        • Geere I.W.
        • Coldman A.
        A three-year study of positive blood cultures, with emphasis on prognosis.
        Rev Infect Dis. 1991; 13: 34-46
        • Love L.J.
        • Schimpff S.C.
        • Schiffer C.A.
        • Wiernik P.H.
        Improved prognosis for granulocytopenic patients with gram-negative bacteremia.
        Am J Med. 1980; 68: 634-647
        • Gill F.A.
        • Robinson R.
        • MacLowry J.G.
        • Levine A.S.
        The relationship of fever, granulocytopenia and antimicrobial therapy to bacteremia in cancer patients.
        Cancer. 1977; 39: 1704-1709
        • Ziegler E.J.
        • McCutchan J.A.
        • Fierer J.
        • et al.
        Treatment of gramnegative bacteremia and shock with human antiserum to a mutant Escherichia coli.
        N Engl J Med. 1979; 307: 1225-1230
        • Andriole V.T.
        Pseudomonas bacteremia: Can antibiotic therapy improve survival?.
        J Lab Clin Invest. 1979; 94 (Editorial): 196-200
        • Bodey G.P.
        • Buckley M.
        • Sathe Y.S.
        • Freireich E.J.
        Quantitative relationship between circulating leukocytes and infection in patients with acute leukemia.
        Ann Intern Med. 1966; 64: 328-340
        • Gurwitz M.J.
        • Brunton J.L.
        • Lank B.A.
        • Ronald A.R.
        • Harding G.K.M.
        • McCulloch D.W.
        Granulocytopenia in hospitalized patients. I. Prognostic factors and etiology of fever.
        Am J Med. 1978; 64: 121-126
        • The EORTC International Antimicrobial Therapy Cooperative Group
        Ceftazidime combined with a short or long course of amikacin for empirical therapy of gram-negative bacteremia in cancer patients with granulocytopenia.
        N Engl J Med. 1987; 317: 1692-1698
        • Pizzo P.A.
        • Hatorn J.W.
        • Heimenz J.
        • et al.
        A randomized trial comparing ceftazidime alone with combination antibiotic therapy in cancer patients with fever and neutropenia.
        N Engl J Med. 1986; 315: 552-558
        • Klastersky J.
        • Meunier-Carpentier F.
        • Prevost J.M.
        Significance of antimicrobial synergism for the outcome of gram-negative sepsis.
        Am J Med Sci. 1977; 273: 157-167
        • Elting L.S.
        • Rubenstein E.B.
        • Rolston K.V.J.
        • Bodey G.P.
        Outcomes of bacteremia in patients with cancer and neutropenia: observation from two decades of epidemiological and clinical trials.
        Clin Infect Dis. 1997; 25: 247-259
        • Funada H.
        • Machi T.
        • Matsuda T.
        Bacteremia complicating acute leukemia with special reference to its incidence and changing etiological patterns.
        Jpn J Clin Oncol. 1988; 18: 239-248

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      Publication history

      Accepted: March 27, 1998
      Received: January 22, 1998

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      DOI: https://doi.org/10.1016/S1201-9712(99)90017-6

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