Comparison Of Clinical Outcome Of Bloodstream Infection Between Pseudomonas Aeruginosa And Acinetobacter Baumannii

Objective:Bloodstream infections is a high morbidity and mortality of disease,Gram-negative bacteria are the most common cause of bloodstream infections,about a quarter of Gram-negative bacillus bloodstream infections from the non-fermentative Gram-negative bacteria,while Acinetobacter baumannii and Pseudomonas aeruginosa among non-fermentative Gram-negative bacteria are the most common pathogens.By comparing the clinical characteristics,antibiotic resistance and clinical prognosis of bloodstream infection between Pseudomonas aeruginosa and Acinetobacter baumannii,this study aims to provide some guidance for the rapid clinical prediction and identification of bloodstream infection caused by Pseudomonas aeruginosa and Acinetobacter baumannii,so as to provide better empirical treatment.Methods:A retrospective cohort study was conducted on 280 adult patients with single microorganism bloodstream infection by Pseudomonas aeruginosa or Acinetobacter baumannii in Shengjing Hospital of China Medical University from 2012 to 2019.Among them,114 cases were infected by Pseudomonas aeruginosa and 166 cases were infected by Acinetobacter baumannii.Clinical characteristics and antibiotic resistance of them were compared.According to the independent risk factors for 14-day mortality of Pseudomonas aeruginosa and Acinetobacter baumannii bloodstream infection,the propensity score matching between Pseudomonas aeruginosa and Acinetobacter baumannii bloodstream infection was performed according to 1:1,and the difference in clinical outcome between them was compared.Results:By comparing the clinical characteristics of bloodstream infection between Pseudomonas aeruginosa and Acinetobacter baumannii,it was found that primary bloodstream infection,urinary tract infection,chemotherapy within 1 month,and malignant blood disease were more common in Pseudomonas aeruginosa bloodstream infection.However,admission to ICU within 1 month,occurrence of trauma,nervous system diseases,invasive procedures within 1 month,use of β-lactamase inhibitors and glycopeptide antibiotics within 1 month were more common in Acinetobacter baumannii bloodstream infection.The antibiotic resistance of Pseudomonas aeruginosa bloodstream infection to ceftazidime,cefepime,meropenem,imipenem,gentamicin,amikacin,tobramycin,gatifloxacin,ciprofloxacin,levofloxacin,piperacillin,ticacillin/clavulanate,piperacillin/tazobactam,cefoperazone/sulb actam were lower than in Acinetobacter baumannii bloodstream infection.Among them,the antibiotic resistance of Pseudomonas aeruginosa bloodstream infection range from0.0% to 34.8%,the antibiotic resistance of Acinetobacter baumannii bloodstream infection to amicacin and levofloxacin are 19.8% and 36.6%,respectively,and the antibiotic resistance to other antibiotics range from 50.7% to 87.5%.After propensity score matching,there was no difference in 3-day(7.6%vs16.7%,P=0.110),7-day(13.6%vs21.2%,P=0.251)and 14-day mortality (16.7%vs25.8%,P=0.201)between Pseudomonas aeruginosa and Acinetobacter baumannii in bloodstream infection.Conclusion:The clinical characteristics of bloodstream infection were different between Pseudomonas aeruginosa and Acinetobacter baumannii.The antibiotic resistance of Acinetobacter baumannii bloodstream infection was higher than that of Pseudomonas aeruginosa bloodstream infection.There was no difference in 3-day,7-day and 14-day mortality between Pseudomonas aeruginosa and Acinetobacter baumannii in bloodstream infection.