PSEUDOMONAS aeruginosa bloodstream infection carried recurrence and mortality, with illness driving risk in Queensland adult cohort.
Recurrence and Mortality After Pseudomonas aeruginosa Bloodstream Infection
Pseudomonas aeruginosa bloodstream infection remains clinically challenging because patients can relapse and many die soon after diagnosis. In a population-based cohort from Queensland, Australia, investigators examined recurrence and mortality after Pseudomonas aeruginosa bloodstream infection over two decades, aiming to identify baseline factors that could support more targeted empiric therapy.
The study included 5,742 patients with Pseudomonas aeruginosa bloodstream infection between 2000 and 2019 and classified outcomes into four groups: death within 30 days, death between 30 days and three years, recurrence, or survival to three years without recurrence. Overall, 20.5% died within 30 days and 21.3% died between 30 days and three years. Recurrence occurred in 4.6% of patients, while 53.6% survived to three years without recurrence.
Comorbidities Signal Higher Risk Profiles
Several baseline conditions were linked with recurrence. Malignancy showed the strongest association, and both metastatic cancer and uncomplicated diabetes were also associated with greater recurrence risk. For mortality, malignancy again emerged as a key risk factor, alongside congestive heart failure, dementia, renal disease, and pulmonary disease. Advancing age was associated with higher odds of death.
Community Onset and Source May Matter
Not all presentations carried the same risk. Community onset infection was associated with a reduced risk of both recurrence and mortality. A genitourinary source was also associated with lower mortality risk and appeared to reduce recurrence risk in this cohort, suggesting that initial context may help refine early management decisions.
Resistance Signals After Recurrence
Among patients who experienced recurrence, resistance emerged to ceftazidime in 10.7% and to ciprofloxacin in 10.1%, while most susceptibility profiles remained stable. Taken together, these findings highlight substantial early and longer-term mortality, a clinically meaningful recurrence burden, and patient factors that may inform empiric therapy for Pseudomonas aeruginosa bloodstream infection.
Reference: Edwards F et al. Recurrence and mortality after Pseudomonas aeruginosa bloodstream infection: a population-based cohort study. Eur J Clin Microbiol Infect Dis. 2025;doi:10.1007/s10096-025-05388-y.
