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Population-Based Study of the Epidemiology and the Risk Factors for Pseudomonas aeruginosa Bloodstream Infection

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Abstract

Background:

Detailed population-based data on the epidemiologyof Pseudomonas aeruginosa bloodstream infectionsare sparse. We sought to describe the incidence rate, riskfactors, and outcomes associated with P. aeruginosa bacteremiain a large Canadian health region.

Patients and Methods:

A retrospective population-basedsurveillance for P. aeruginosa bacteremia was conductedin the Calgary Health Region (CHR, population:approx. 1.2 million) during the period from 2000 to2006.

Results:

A total of 284 incident cases of P. aeruginosabacteremia were identified in CHR residents, correspondingto an annual incidence rate of 3.6/100,000.Nosocomial acquisition accounted for 45% of cases,healthcare-associated community onset for 34% of cases,and community-acquired (CA) cases for 21%. Relative tothe general population, risk factors for bloodstreaminfection included male sex, increasing age, hemodialysis,solid organ transplant, diagnosis of cancer, heartdisease, HIV infection, diabetes mellitus, and/or chronicobstructive airway disease (COPD). Overall mortality was29%. Factors associated with mortality in univariateanalysis included pulmonary focus of infection andco-morbidities, including chronic liver disease, substanceabuse, heart disease, COPD, and cancer, and increasedwith the burden of co-morbidities. Despite thosepatients with CA disease having fewer co-morbidities,they had a significantly higher mortality rate thaneither healthcare-associated cases or nosocomial cases(RR 1.88, p = 0.05).

Conclusions:

This study documents that P. aeruginosabacteremic disease is responsible for a significant burdenof illness in general populations and identifies thosegroups at increased risk of infection and subsequentmortality. This information can be used to identify thoseindividuals likely to benefit from empiric anti-pseudomonaltherapies.

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Author information

Authors and Affiliations

  1. Division of Infectious Disease, Dept. of Medicine, Calgary Health Region, Calgary, Alberta, Canada

    M. D. Parkins, D. B. Gregson & K. B. Laupland

  2. Dept. of Microbiology and Infectious Disease, Health Sciences Center,University of Calgary, Calgary, Alberta, Canada

    M. D. Parkins & D. B. Gregson

  3. Dept. of Pathology and Laboratory Medicine, University of Calgary,Calgary Health Region, Calgary, Alberta, Canada

    D. B. Gregson, J. D. D. Pitout & K. B. Laupland

  4. Dept. of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada

    K. B. Laupland

  5. Division of Microbiology, Calgary Laboratory Services, Calgary, Alberta, Canada

    J. D. D. Pitout, T. Ross & K. B. Laupland

  6. Dept. of Medicine, Alberta Health Services, Foothills Medical Center, Calgary, Alberta, Canada T2N 2T9

    M. D. Parkins

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  1. M. D. Parkins
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  3. J. D. D. Pitout
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Correspondence to M. D. Parkins.

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Parkins, M.D., Gregson, D.B., Pitout, J.D.D. et al. Population-Based Study of the Epidemiology and the Risk Factors for Pseudomonas aeruginosa Bloodstream Infection. Infection 38, 25–32 (2010). https://doi.org/10.1007/s15010-009-9145-9

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  • DOI: https://doi.org/10.1007/s15010-009-9145-9

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