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Titolo:
Factors associated with improved outcome of Pseudomonas aeruginosa bacteremia in a Finnish university hospital
Autore:
Kuikka, A; Valtonen, VV;
Indirizzi:
Univ Helsinki, Dept Bacteriol & Immunol, Haartman Inst, FIN-00014 Helsinki, Univ Helsinki Helsinki Finland FIN-00014 rtman Inst, FIN-00014 Helsinki, Univlandsinki, Cent Hosp, Dept Med, Div Infect Dis, FIN-00029 Helsinki, Fin Univ Helsinki Helsinki Finland FIN-00029 ct Dis, FIN-00029 Helsinki, Fin
Titolo Testata:
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES
fascicolo: 10, volume: 17, anno: 1998,
pagine: 701 - 708
SICI:
0934-9723(199810)17:10<701:FAWIOO>2.0.ZU;2-P
Fonte:
ISI
Lingua:
ENG
Soggetto:
NEUTROPENIC CANCER-PATIENTS; POSITIVE BLOOD CULTURES; GRANULOCYTOPENIC PATIENTS; CLINICAL-SIGNIFICANCE; EPISODES; FUNGEMIA; EPIDEMIOLOGY; INFECTIONS; SEPTICEMIA; MANAGEMENT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
31
Recensione:
Indirizzi per estratti:
Indirizzo: Kuikka, A Univelsinki,i, Dept Bacteriol & Immunol, Haartman Inst, POB 21, FIN-00014 H Univ Helsinki POB 21 Helsinki Finland FIN-00014 21, FIN-00014 H
Citazione:
A. Kuikka e V.V. Valtonen, "Factors associated with improved outcome of Pseudomonas aeruginosa bacteremia in a Finnish university hospital", EUR J CL M, 17(10), 1998, pp. 701-708

Abstract

All 134 episodes of bacteremia caused solely by Pseudomonas aeruginosa in a university hospital in the periods 1976-1982 and 1992-1996 were reviewed retrospectively to determine the clinical manifestations, outcome and prognostic factors. The mortality for the 30-day interval after drawing the first positive blood culture was 41%, but dropped from 53% in the first period to 29% in the second period (P = 0.006). Mortality was highest in patients treated with an aminoglycoside only, as against those treated with other appropriate antibiotics (55% versus 25%, P = 0.001). Over the two decades studied, use of an aminoglycoside only decreased, use of paracetamol (= acetaminophen) increased, and removal of both urinary and blood vessel catheters became more common. The mortality was 18% in patients with catheter removal(46% in the other patients, P = 0.017) and 27% in patients who received paracetamol around the time of drawing the first positive blood culture (50% for the other patients, P = 0.010). Logistic regression analysis showed that shock, central nervous system involvement, preceding thromboembolism and rapidly fatal underlying disease were associated with a fatal outcome, whereas catheter removal, appropriate antibiotic therapy and paracetamol therapy were associated with survival. The improved prognosis of Pseudomonas aeruginosa bacteremia over the two decades is thus due mainly to three changes in management of the infection: the more frequent use of new anti-pseudomonal beta-lactams and ciprofloxacin instead of aminoglycosides as monotherapy; the more frequent practice of removing catheters; and the increased use of paracetamol around the time of drawing the first positive blood sample.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 18/09/20 alle ore 09:24:35