In May 2023, a  study led by Professor XiaoFan Zhu from Chinese Academy of Medical Sciences Blood Disease Hospital (Institute of Hematology, Chinese Academy of Medical Sciences) was published in the international academic journal ——Frontiers in Cellular and Infection Microbiology. The title of the study is "Assessment of mortality-related risk factors and effective antimicrobial regimens for treatment of bloodstream infections caused by carbapenem-resistant Pseudomonas aeruginosa in patients with hematological diseases". This study emphasizes the importance of identifying high-risk MDR infections and selecting appropriate antibiotic therapy to improve patient survival.

Pseudomonas aeruginosa is a significant nosocomial pathogen responsible for various infections, including pneumonia, bacteremia, and urinary tract infections. However, the emergence of carbapenem-resistant Pseudomonas aeruginosa (CRPA) and multidrug-resistant Pseudomonas aeruginosa (MDR-PA) has posed a severe challenge to antibiotic therapy. Infections caused by CRPA or MDR-PA are associated with higher mortality rates. Therefore, it is imperative to explore risk factors and effective antimicrobial regimens for the treatment of bloodstream infections in patients with hematological diseases.

The retrospective study was conducted at a blood diseases hospital in China and included hematological patients diagnosed with CRPA bacteremia between January 2014 and August 2022. The primary endpoint was all-cause mortality at day 30, and secondary endpoints included 7-day and 30-day clinical cure rates. Multivariable Cox regression analysis was used to identify mortality-related risk factors. The study also compared the efficacy of traditional and novel antibiotic regimens.

(Front Cell Infect Microbiol . 2023 Jun 21:13:1156651.)

The study included 100 patients infected with CRPA bacteremia, with a 30-day mortality rate of 21.0%. Neutropenia lasting more than 7 days, higher Pitt bacteremia score, higher Charlson comorbidity index, and bacteremia due to MDR-PA were identified as independent risk factors for 30-day mortality. A subsequent multivariable Cox regression analysis revealed that definitive regimens containing ceftazidime-avibactam (CAZ-AVI) were associated with lower mortality in CRPA bacteremia and MDR-PA bacteremia. The study also highlighted the favorable outcomes of CAZ-AVI-based regimens for treating DTR-PA infections.

(Front Cell Infect Microbiol . 2023 Jun 21:13:1156651.)

This study provides valuable insights into mortality-related risk factors and effective antimicrobial regimens for the treatment of bloodstream infections caused by CRPA and MDR-PA in patients with hematological diseases. The findings can guide clinicians in making informed decisions regarding treatment strategies, ultimately improving patient outcomes.

In patients with hematological diseases and CRPA bacteremia, the 30-day mortality rate was 21.0%. Neutropenia >7 days after bloodstream infection, higher Pitt bacteremia score, higher Charlson comorbidity index, and bacteremia due to MDR-PA increased the risk of mortality. CAZ-AVI-based regimens were found to be effective alternatives for CRPA or MDR-PA bacteremia. The study emphasizes the importance of identifying high-risk MDR infections and selecting appropriate antibiotic therapy to improve patient survival.