{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T22:14:08Z","timestamp":1791756848338,"version":"4.3.4"},"reference-count":30,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T00:00:00Z","timestamp":1702598400000},"content-version":"unspecified","delay-in-days":348,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ASHE"],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S2732494X23004552_as1\">\n\t    <jats:title>Objective:<\/jats:title>\n\t    <jats:p><jats:italic>Pseudomonas aeruginosa<\/jats:italic> bloodstream infection (PA-BSI) and COVID-19 are independently associated with high mortality. We sought to demonstrate the impact of COVID-19 coinfection on patients with PA-BSI.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X23004552_as2\">\n\t    <jats:title>Design:<\/jats:title>\n\t    <jats:p>Retrospective cohort study.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X23004552_as3\">\n\t    <jats:title>Setting:<\/jats:title>\n\t    <jats:p>Veterans Health Administration.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X23004552_as4\">\n\t    <jats:title>Patients:<\/jats:title>\n\t    <jats:p>Hospitalized patients with PA-BSI in pre-COVID-19 (January 2009 to December 2019) and COVID-19 (January 2020 to June 2022) periods. Patients in the COVID-19 period were further stratified by the presence or absence of concomitant COVID-19 infection.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X23004552_as5\">\n\t    <jats:title>Methods:<\/jats:title>\n\t    <jats:p>We characterized trends in resistance, treatment, and mortality over the study period. Multivariable logistic regression and modified Poisson analyses were used to determine the association between COVID-19 and mortality among patients with PA-BSI. Additional predictors included demographics, comorbidities, disease severity, antimicrobial susceptibility, and treatment.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X23004552_as6\">\n\t    <jats:title>Results:<\/jats:title>\n\t    <jats:p>A total of 6,714 patients with PA-BSI were identified. Throughout the study period, PA resistance rates decreased. Mortality decreased during the pre-COVID-19 period and increased during the COVID-19 period. Mortality was not significantly different between pre-COVID-19 (24.5%, 95% confidence interval [CI] 23.3\u201328.6) and COVID-19 period\/COVID-negative (26.0%, 95% CI 23.5\u201328.6) patients, but it was significantly higher in COVID-19 period\/COVID-positive patients (47.2%, 35.3\u201359.3). In the modified Poisson analysis, COVID-19 coinfection was associated with higher mortality (relative risk 1.44, 95% CI 1.01\u20132.06). Higher Charlson Comorbidity Index, higher modified Acute Physiology and Chronic Health Evaluation score, and no targeted PA-BSI treatment within 48 h\u00a0were also predictors of higher mortality.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X23004552_as7\">\n\t    <jats:title>Conclusions:<\/jats:title>\n\t    <jats:p>Higher mortality was observed in patients with COVID-19 coinfection among patients with PA-BSI. Future studies should explore this relationship in other settings and investigate potential SARS-CoV-2 and PA synergy.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/ash.2023.455","type":"journal-article","created":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T06:29:02Z","timestamp":1702621742000},"source":"Crossref","is-referenced-by-count":2,"title":["Association of COVID-19 coinfection with increased mortality among patients with <i>Pseudomonas aeruginosa<\/i> bloodstream infection in the Veterans Health Administration system"],"prefix":"10.1017","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4364-8141","authenticated-orcid":false,"given":"Leila S.","family":"Hojat","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2966-2940","authenticated-orcid":false,"given":"Brigid M.","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Perez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1380-9824","authenticated-orcid":false,"given":"Maria F.","family":"Mojica","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3331-3340","authenticated-orcid":false,"given":"Mendel E.","family":"Singer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Bonomo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren H.","family":"Epstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2023,12,15]]},"reference":[{"key":"S2732494X23004552_ref16","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.jcrc.2018.09.005","article-title":"An automated computerized critical illness severity scoring system derived from APACHE III: modified APACHE","volume":"48","author":"Fortis","year":"2018","journal-title":"J Crit Care"},{"key":"S2732494X23004552_ref24","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1515\/dx-2020-0114","article-title":"Delayed treatment of bacteremia during the COVID-19 pandemic","volume":"8","author":"Miyagami","year":"2021","journal-title":"Diagnosis (Berl)."},{"key":"S2732494X23004552_ref18","unstructured":"18. 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