{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T16:59:51Z","timestamp":1793120391455,"version":"4.5.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T00:00:00Z","timestamp":1704412800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Background<\/jats:title>\n \n Pseudomonas aeruginosa (P. aeruginosa)<\/jats:italic>\n accounts for high antimicrobial resistance and mortality rates of bloodstream infections (BSIs). We aim to investigate incidence, antimicrobial resistance and risk factors for mortality of\n P<\/jats:italic>\n .\n aeruginosa<\/jats:italic>\n BSIs among inpatients.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A retrospective cohort study were conducted at two tertiary hospitals in 2017\u20132021. Medical and laboratory records of all inpatients diagnosed with\n P<\/jats:italic>\n .\n aeruginosa<\/jats:italic>\n BSIs were reviewed. A generalized linear mixed model was used to identify risk factors for mortality.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 285 patients with\n P<\/jats:italic>\n .\n aeruginosa<\/jats:italic>\n BSIs were identified. Incidence of\n P<\/jats:italic>\n .\n aeruginosa<\/jats:italic>\n BSIs fluctuated between 2.37 and 3.51 per 100,000 patient-days over the study period. Out of 285\n P<\/jats:italic>\n .\n aeruginosa<\/jats:italic>\n isolates, 97 (34.04%) were carbapenem-resistant (CR) and 75 (26.32%) were multidrug-resistant (MDR). These isolates showed low resistance to aminoglycosides (9.51\u201311.62%), broad-spectrum cephalosporins (17.19\u201317.61%), fluoroquinolones (17.25\u201319.43%), and polymyxin B (1.69%). The crude 30-day mortality rate was 17.89% (51\/285). Healthcare costs of patients with MDR\/CR isolates were significantly higher than those of patients with non-MDR\/CR isolates (\n P<\/jats:italic>\n &lt; 0.001\/=0.002). Inappropriate definitive therapy [adjusted odds ratio (aOR) 4.47, 95% confidence interval (95% CI) 1.35\u201314.77;\n P<\/jats:italic>\n = 0.014], ICU stay (aOR 2.89, 95% CI: 1.26\u20136.63;\n P<\/jats:italic>\n = 0.012) and corticosteroids use (aOR 2.89, 95% CI: 1.31\u20136.41;\n P<\/jats:italic>\n = 0.009) were independently associated with 30-day mortality.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Incidence of\n P<\/jats:italic>\n .\n aeruginosa<\/jats:italic>\n BSIs showed an upward trend during 2017\u20132020 but dropped in 2021. MDR\/CR\n P<\/jats:italic>\n .\n aeruginosa<\/jats:italic>\n BSIs are associated with higher healthcare costs. Awareness is required that patients with inappropriate definitive antimicrobial therapy, ICU stay and corticosteroids use are at higher risk of death from\n P<\/jats:italic>\n .\n aeruginosa<\/jats:italic>\n BSIs.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2023.1294141","type":"journal-article","created":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T00:28:21Z","timestamp":1704414501000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":18,"title":["Incidence, antimicrobial resistance and mortality of Pseudomonas aeruginosa bloodstream infections among hospitalized patients in China: a retrospective observational multicenter cohort study from 2017 to 2021"],"prefix":"10.3389","volume":"11","author":[{"given":"Shuzhen","family":"Xiao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianghui","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lizhong","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengyuan","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,1,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1016\/S0140-6736(19)32989-7","article-title":"Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study","volume":"395","author":"Rudd","year":"2020","journal-title":"Lancet."},{"key":"B2","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1186\/s13756-019-0520-8","article-title":"A retrospective analysis of Pseudomonas aeruginosa bloodstream infections: prevalence, risk factors, and outcome in carbapenem-susceptible and -non-susceptible infections","volume":"8","author":"Shi","year":"2019","journal-title":"Antimicrob Resist Infect Control."},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00355-19","article-title":"The microbiology of bloodstream infection: 20-year trends from the SENTRY antimicrobial surveillance program","author":"Diekema","year":"2019","journal-title":"Antimicrob Agents Chemother."},{"key":"B4","doi-asserted-by":"publisher","first-page":"e02671","DOI":"10.1128\/AAC.02671-16","article-title":"Results from a 13-year prospective cohort study show increased mortality associated with bloodstream infections caused by Pseudomonas aeruginosa compared to other bacteria","volume":"61","author":"Thaden","year":"2017","journal-title":"Antimicrob Agents Chemother."},{"key":"B5","doi-asserted-by":"publisher","first-page":"2117","DOI":"10.1007\/s40265-021-01635-6","article-title":"The epidemiology and pathogenesis and treatment of Pseudomonas aeruginosa infections: an update","volume":"81","author":"Reynolds","year":"2021","journal-title":"Drugs."},{"key":"B6","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1016\/j.jgar.2022.06.026","article-title":"Clinical impact of time-to-positivity of blood cultures on mortality in patients with Pseudomonas aeruginosa bacteremia","volume":"30","author":"Rolo","year":"2022","journal-title":"J Glob Antimicrob Resist."},{"key":"B7","doi-asserted-by":"publisher","first-page":"2345","DOI":"10.1080\/07853890.2021.2012588","article-title":"Clinical outcomes, molecular epidemiology and resistance mechanisms of multidrug-resistant Pseudomonas aeruginosa isolated from bloodstream infections from Qatar","volume":"53","author":"Sid Ahmed","year":"2021","journal-title":"Ann Med."},{"key":"B8","doi-asserted-by":"publisher","first-page":"e14409","DOI":"10.1111\/ijcp.14409","article-title":"A ten-year surveillance of P aeruginosa bloodstream infections in a tertiary care hospital: trends and risk factors for mortality","volume":"75","author":"Ababneh","year":"2021","journal-title":"Int J Clin Practice."},{"key":"B9","doi-asserted-by":"publisher","first-page":"4115","DOI":"10.2147\/IDR.S268744","article-title":"Risk factors for mortality of inpatients with Pseudomonas aeruginosa bacteremia in China: impact of resistance profile in the mortality","volume":"13","author":"Zhang","year":"2020","journal-title":"Infect Drug Resist."},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01759-19","article-title":"Predictors of mortality in bloodstream infections caused by Pseudomonas aeruginosa and impact of antimicrobial resistance and bacterial virulence","author":"Recio","year":"2020","journal-title":"Antimicrob Agents Chemother."},{"key":"B11","doi-asserted-by":"publisher","first-page":"2774","DOI":"10.1093\/jac\/dkz245","article-title":"Mortality dynamics of Pseudomonas aeruginosa bloodstream infections and the influence of defective OprD on mortality: prospective observational study","volume":"74","author":"Yoon","year":"2019","journal-title":"J Antimicrob Chemother."},{"key":"B12","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1016\/j.jhin.2016.11.014","article-title":"Long-term mortality following Pseudomonas aeruginosa bloodstream infection","volume":"95","author":"McCarthy","year":"2017","journal-title":"J Hosp Infection."},{"key":"B13","first-page":"413","article-title":"BRICS report of 2020: the bacterial composition and antimicrobial resistance profile of clinical isolates from bloodstream infections in China","volume":"14","author":"Chen","year":"2021","journal-title":"Chin J Clin Infect Dis."},{"key":"B14","doi-asserted-by":"publisher","first-page":"e27","DOI":"10.1038\/emi.2016.22","article-title":"Mortality attributable to carbapenem-resistant Pseudomonas aeruginosa bacteremia: a meta-analysis of cohort studies","volume":"5","author":"Zhang","year":"2016","journal-title":"Emerg Microbes Infect."},{"key":"B15","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1016\/j.jmii.2013.07.009","article-title":"Clinical characteristics and risk factors for mortality in cefepime-resistant Pseudomonas aeruginosa bacteremia","volume":"48","author":"Su","year":"2015","journal-title":"J Microbiol Immunol Infect."},{"key":"B16","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/0196-6553(88)90053-3","article-title":"CDC definitions for nosocomial infections, 1988","volume":"16","author":"Garner","year":"1988","journal-title":"Am J Infect Control."},{"key":"B17","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1016\/j.ajic.2008.03.002","article-title":"CDC\/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting","volume":"36","author":"Horan","year":"2008","journal-title":"Am J Infect Control."},{"key":"B18","doi-asserted-by":"publisher","first-page":"S174","DOI":"10.1093\/infdis\/jiz559","article-title":"A retrospective analysis of risk factors and outcomes of carbapenem-resistant Klebsiella pneumoniae bacteremia in nontransplant patients","volume":"221","author":"Xiao","year":"2020","journal-title":"J Hosp Infect."},{"key":"B19","doi-asserted-by":"publisher","first-page":"e22","DOI":"10.1093\/cid\/cit278","article-title":"A guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2013 recommendations by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM)(a)","volume":"57","author":"Baron","year":"2013","journal-title":"Clin Infect Dis"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1168096","DOI":"10.3389\/fcimb.2023.1168096","article-title":"Resistance genomics and molecular epidemiology of high-risk clones of ESBL-producing Pseudomonas aeruginosa in young children","volume":"13","author":"Patil","year":"2023","journal-title":"Front Cell Infect Microbiol."},{"key":"B21","volume-title":"Clinical and Laboratory Standards Institute (CLSI): Performance Standards for Antimicrobial Susceptibility Testing","author":"Wayne","year":"2021"},{"key":"B22","doi-asserted-by":"publisher","first-page":"3969","DOI":"10.1128\/AAC.02467-12","article-title":"Bacterial and clinical characteristics of health care- and community-acquired bloodstream infections due to Pseudomonas aeruginosa","volume":"57","author":"Hattemer","year":"2013","journal-title":"Antimicrob Agents Chemother"},{"key":"B23","first-page":"163","article-title":"Evaluation of survival data and two new rank order statistics arising in its consideration","volume":"50","author":"Mantel","year":"1966","journal-title":"Cancer Chemother Rep."},{"key":"B24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v033.i01","article-title":"Regularization paths for generalized linear models via coordinate descent","volume":"33","author":"Friedman","year":"2010","journal-title":"J Stat Softw."},{"key":"B25","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1017\/ice.2020.1351","article-title":"Risk factors for carbapenemase-producing organisms among inpatients in Scotland: a national matched case-control study","volume":"42","author":"Zhao","year":"2021","journal-title":"Infect Control Hosp Epidemiol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1136\/bmjqs-2021-014243","article-title":"Impact of the COVID-19 pandemic on the incidence and mortality of hospital-onset bloodstream infection: a cohort study","volume":"31","author":"Valik","year":"2022","journal-title":"Br Med J Qual Saf."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1748","DOI":"10.1093\/cid\/ciab688","article-title":"The impact of coronavirus disease 2019 (COVID-19) on healthcare-associated infections","volume":"74","author":"Baker","year":"2022","journal-title":"Clin Infect Dis."},{"key":"B28","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.ijid.2021.07.065","article-title":"Bloodstream infections in the COVID-19 era: results from an Italian multi-centre study","volume":"111","author":"Pasquini","year":"2021","journal-title":"Int J Infect Dis."},{"key":"B29","doi-asserted-by":"publisher","first-page":"105847","DOI":"10.1016\/j.ijantimicag.2019.11.004","article-title":"Risk factors for mortality among patients with Pseudomonas aeruginosa bacteraemia: a retrospective multicentre study","volume":"55","author":"Babich","year":"2020","journal-title":"Int J Antimicrob Agents."},{"key":"B30","first-page":"630","article-title":"Pseudomonas aeruginosa bacteraemia: a five-year analysis of epidemiology, clinical profiles, and outcome in a Malaysian district hospital","volume-title":"Med J Malaysia.","author":"Tan","year":"2021"},{"key":"B31","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1016\/j.jhin.2021.01.028","article-title":"Epidemiology of and risk factors for mortality due to carbapenemase-producing organisms (CPO) in healthcare facilities","volume":"110","author":"Zhao","year":"2021","journal-title":"J Hosp Infect."},{"key":"B32","doi-asserted-by":"publisher","first-page":"94","DOI":"10.5492\/wjccm.v1.i4.94","article-title":"Infection control in severely burned patients","volume":"1","author":"Coban","year":"2012","journal-title":"World J Crit Care Med."},{"key":"B33","doi-asserted-by":"publisher","first-page":"1135","DOI":"10.3389\/fmicb.2018.01135","article-title":"Molecular typing and carbapenem resistance mechanisms of Pseudomonas aeruginosa isolated from a Chinese Burn Center From 2011 to 2016","volume":"9","author":"Yin","year":"2018","journal-title":"Front Microbiol."},{"key":"B34","doi-asserted-by":"publisher","first-page":"e273","DOI":"10.3346\/jkms.2021.36.e273","article-title":"Antimicrobial susceptibility trends and risk factors for antimicrobial resistance in Pseudomonas aeruginosa bacteremia: 12-year experience in a tertiary hospital in Korea","volume":"36","author":"Kang","year":"2021","journal-title":"J Korean Med Sci."},{"key":"B35","doi-asserted-by":"publisher","first-page":"514","DOI":"10.3390\/jcm9020514","article-title":"Risk factors for mortality among patients with Pseudomonas aeruginosa bloodstream infections: what is the influence of XDR phenotype on outcomes?","volume":"9","author":"Montero","year":"2020","journal-title":"J Clin Med."},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01709-16","article-title":"Increased costs associated with bloodstream infections caused by multidrug-resistant gram-negative bacteria are due primarily to patients with hospital-acquired infections","author":"Thaden","year":"2017","journal-title":"Antimicrob Agents Chemother."},{"key":"B37","doi-asserted-by":"crossref","first-page":"189","DOI":"10.47102\/annals-acadmedsg.V41N5p189","article-title":"The excess financial burden of multidrug resistance in severe gram-negative infections in Singaporean hospitals","volume":"41","author":"Ng","year":"2012","journal-title":"Ann Acad Med Singapore."},{"key":"B38","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1016\/j.ijantimicag.2015.12.019","article-title":"Clinical characteristics and antimicrobial patterns in complicated intra-abdominal infections: a 6-year epidemiological study in southern China","volume":"47","author":"Ouyang","year":"2016","journal-title":"Int J Antimicrob Agents."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1294141\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T00:28:28Z","timestamp":1704414508000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1294141\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,5]]},"references-count":38,"alternative-id":["10.3389\/fpubh.2023.1294141"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2023.1294141","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,5]]},"article-number":"1294141"}}