PSEUDOMONAS-AERUGINOSA SEPTICEMIA HOST-RE LATED RISK-FACTORS IN 82 EPISODES

Objectives: The prognosis of septicaemia due to Pseudomonas aeruginosa is severe with mortality ranging from 32 to 73%, We retrospectively s tudied 82 episodes in order to determine whether risk Factors could be identified. Methods: Eighty-two episodes of Pseudomonas aeruginosa se pticaemia, observed between 1986 and 1991, were analyzed. Risk of deat h within 2 days of the first positive blood culture (mortality = 19.5% ) were assessed with univariate and multivariate analyses. Results: Pa tient age ranged from 1 to 92 years, Most had been hospitalized in med ical wards (49%) or intensive care units (28%) (NS), The type of septi caemia (several bacteria in 21%), the source of the infection (nosocom ial in 78%), portal, predisposing factors (cancer, haematologic diseas e: 54%) and MacCabe index were not significantly correlated with risk of death at two days following first positive blood culture. With univ ariate analysis body temperature below 38,5 degrees C was significant (p = 0.007) for death at day 2 and appropriate antibiotic treatment af ter diagnosis was significant (p < 0.001) for absence of death on day 2. For multivariate analysis, chemotherapy and shock syndrome were sig nificant (p = 0.005 and 0.09 respectively) for death at day 2 and appr opriate antibiotic treatment was significant (p = 0.005) for absence o f death on day 2. Conclusion: Antibiotic prescription appears to be th e most easily controlled significant factor predictive of outcome in P seudomonas aeruginosa septicaemia.