Pseudomonas aeruginosa bacteraemia in burns patients: Risk factors and outcomes

Introduction We aimed to identify the risk factors for and outcomes of Pseudomonas aeruginosa bacteraemia in adult burns patients Method All adult burns patients who developed a Gram negative bacteraemia over a period of 7 years were included Retrospective data analysed included patient demographics organisms cultured antibiotic susceptibility patterns isolation of P aeruginosa in non blood isolates treatment length of stay and mortality Results Forty three patients developed a Gram negative bacteraemia over the study period 12 of whom had Pseudomonas bacteraemia during the course of their admission In eight patients (18 6%) P aeruginosa was the first Gram negative isolated The only factor predicting P aeruginosa bacteraemia as a first episode (compared to another Gram negative) was prior isolation of Pseudomonas at other sites (wound sites urine or sputum) Overall length of stay was less in patients who developed P aeruginosa as a first episode mainly because of increased mortality in this group Prior non blood isolates of P aeruginosa could have correctly predicted the sensitivity pattern of the strain of P aeruginosa organism in 75% of patients who did not receive appropriate initial antibiotics Conclusion Prior colonisation with P aeruginosa predicts P aeruginosa in blood cultures as opposed to other Gram negative bacteria Clinicians should have a high index of suspicion for P aeruginosa bacteraemia where a septic burns patient has a prior history of non blood P aeruginosa cultures Empirical antibiotic regimes based on the antibiotic sensitivity patterns of previous non blood P aeruginosa isolates in each patient should be given at the time blood cultures are taken (C) 2010 Elsevier Ltd and ISBI All rights reserved