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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)
Cheol-In KangDoo Ryeon ChungKyong Ran PeckJae-Hoon Song
Keimyung Author(s)
Ryu, Seong Yeol
Department
Dept. of Internal Medicine (내과학)
Journal Title
American Journal of Emergency Medicine
Issued Date
2012
Volume
30
Issue
7
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.
Keimyung Author(s)(Kor)
류성열
Publisher
School of Medicine
Citation
Cheol-In Kang et al. (2012). Clinical predictors of Pseudomonas aeruginosa or Acinetobacter baumannii bacteremia in patients admitted to the ED. American Journal of Emergency Medicine, 30(7), 1169–1175. doi: 10.1016/j.ajem.2011.08.021
Type
Article
ISSN
0735-6757
Source
http://lps3.www.sciencedirect.com.proxy.dsmc.or.kr/science/article/pii/S073567571100413X?via%3Dihub
DOI
10.1016/j.ajem.2011.08.021
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/34925
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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