Epidemiology and prognosis of Pseudomonas aeruginosa bacteremia in a tertiary care center.

Objective. To describe the epidemiology and prognosis of P. aeruginosa bloo dstream infections in a tertiary-care center. Design. Retrospective analysi s. Setting. Tertiary-care teaching hospital in Mexico City. Patients. All c ases of P. aeruginosa bacteremia diagnosed from 1981 to 1994. Data. Relevan t demographic, clinical and therapeutic variables were analyzed. Results. A total of 153 bacteremias were found between 1981 and 1994, with a mean pre valence of 4.1 episodes per 1000 hospital discharges. Twenty-five percent o f the infections derived from the biliary tract, and the most frequent unde rlying diseases were hematologic malignancies. The overall crude mortality was 46% (70/153) whereas mortality in the nosocomially-acquired episodes wa s 47% (58/124). Mortality within the first 72 h was 24% (37/153). A multiva riate analysis showed six risk factors associated with a fatal outcome: age greater than or equal to 40 years, shock, mechanical ventilation, prior us e of antibiotics, splenectomy and inappropriate selection of antibiotics. C onclusion. The identification of risk factors, and therefore a prompt insta uration of specific antibiotic therapy, improved the prognosis of these sev erely ill patients.