Multidrug-Resistant Pseudomonas Aeruginosa Bloodstream Infections: Analysis of Trends in Prevalence and Epidemiology

摘要

To the Editor: Multidrug-resistant(MD R) Pseudomonas aeruginosabloodstream infection has beendescribed only in patients with cysticfibrosis (1) and in isolated outbreaksin intensive-care unit (ICU) or neo-plastic patients (2-4). We investigatedthe percentage and clinical findings ofpatients with P. aeruginosa bacteremiahaving MDR strains in a 1,700-beduniversity hospital in Rome, Italy,over a 10-year period (1990-1999).All consecutive patients with thefirst episode of community- or hospi-tal-acquired P. aeruginosa bacteremia,according to the definition of the Cen-ters for Disease Control and Preven-tion (5), were included in the analysis.The term MDR P. aeruginosa coveredresistance to ciprofloxacin, ceftazi-dime, imipenem, gentamicin, and pip-eracillin. In patients with P.aeruginosa bacteremia, we evaluatedage, gender, type of infection (hospitalor community acquired), duration ofhospitalization, risk factors, clinicalfindings, and outcome. Prognosisimmediately before bacteremia devel-oped was determined with the revisedAcute Physiology and Chronic HealthEvaluation (APACHE) III system (6).