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Clinical predictors of Pseudomonas aeruginosa or Acinetobacter baumannii bacteremia in patients admitted to the ED

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Author(s)
류성열
Alternative Author(s)
Ryu, Seong Yeol
Publication Year
2012
Abstract
The identification of clinical characteristics that could identify patients at high risk for
Pseudomonas aeruginosa or Acinetobacter baumannii bacteremia would aid clinicians in the
appropriate management of these life-threatening conditions, especially in patients admitted to the
emergency department (ED) with community-onset infections. To determine clinical risk factors for
P aeruginosa or A baumannii bacteremia in patients with community-onset gram-negative bacteremia
(GNB), a post hoc analysis of a nationwide bacteremia surveillance database including patients with
microbiologically documented GNB was performed. Ninety-six patients with P aeruginosa or
A baumannii bacteremia were compared with 1230 patients with Escherichia coli or Klebsiella
pneumoniae bacteremia. A solid tumor or hematologic malignancy was more likely to be associated
with P aeruginosa or A baumannii bacteremia, whereas concurrent neurologic disease was less
frequently seen. In regards to the site of infection, pneumonia was more common in P aeruginosa or
A baumannii bacteremia, whereas a urinary tract infection was less frequently seen. Factors associated
with P aeruginosa or A baumannii bacteremia in multivariate analysis included pneumonia (odds ratio
[OR], 3.60; 95% confidence interval [CI], 1.86-6.99), hematologic malignancy (OR, 2.71; 95% CI,
1.26-5.84), male sex (OR, 2.17; 95% CI, 1.31-3.58), solid tumor (OR, 1.89; 95% CI, 1.15-3.12), and
health-care–associated infection (OR, 1.88; 95% CI, 1.48-2.41). Our data suggest that an initial
empirical antimicrobial coverage of P aeruginosa or A baumannii bacteremia should be seriously
considered in patients with pneumonia, a hematologic malignancy, solid tumor, or health-care–
associated infection, when GNB is suspected, even in community-onset infections.
© 2012 Elsevier Inc. All rights reserved.
Department
Dept. of Internal Medicine (내과학)
Publisher
School of Medicine
Citation
American Journal of Emergency Medicine, Vol.30(7) : 1169-1175, 2012
Type
Article
ISSN
0735-6757
DOI
10.1016/j.ajem.2011.08.021
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/34925
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