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Open Access Research article

Pseudomonas aeruginosa bacteremia in patients with liver cirrhosis: a comparison with bacteremia caused by Enterobacteriaceae

Ji Hwan Bang12, Younghee Jung1, Shinhye Cheon1, Chung Jong Kim1, Kyung Ho Song1, Pyeong Gyun Choe1, Wan Beom Park12, Eu Suk Kim1, Sang Won Park1, Hong Bin Kim1, Myoung-don Oh1, Hyo-Suk Lee1 and Nam Joong Kim1*

Author Affiliations

1 Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro Jongno-gu, Seoul, 110-744, Republic of Korea

2 Division of Infectious Diseases, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, Republic of Korea

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BMC Infectious Diseases 2013, 13:332  doi:10.1186/1471-2334-13-332

Published: 19 July 2013

Abstract

Background

This study was performed to detect risk factors for Pseudomonas aeruginosa bacteremia in patients with liver cirrhosis.

Methods

A retrospective case–control study was designed to identify risk factors for P. aeruginosa bacteremia in cirrhotic patients. The cases were cirrhotic patients with P. aeruginosa bacteremia and the controls were cirrhotic patients with Enterobacteriaceae bacteremia.

Results

Sixty-one cases and the same number of controls were enrolled. In a multivariate analysis, younger age {adjusted odds ratio (aOR) per one year: 0.96, 95% confidence interval: 0.93 - 0.99}, nosocomial acquisition (aOR 3.87, 95% confidence interval: 1.50 - 9.94), preexisting biliary disease (aOR 4.79, 95% confidence interval: 1.92 - 10.47), and recent exposure to immunosuppressive agent (aOR 3.10, 95% confidence interval: 1.23 - 7.82) were associated with P. aeruginosa bacteremia. In the case group the frequency of appropriate initial antibiotic regimens was considerably lower than in the control group: 29.5% vs. 65.6% (P <0.01). However, thirty day mortality did not differ significantly between cases and controls (19.7% vs. 24.6%).

Conclusions

Nosocomial acquisition, preexisting biliary disease, and recent use of immunosuppressive agents are strong predictive factors for P. aeruginosa bacteremia in cirrhotic patients.

Keywords:
Pseudomonas aeruginosa; Bacteremia; Liver cirrhosis