Increased risk of death with recurrent Pseudomonas aeruginosa bacteremia.

This study aimed to characterize recurrent Pseudomonas aeruginosa blood stream infection (BSI). Positive blood cultures for P. aeruginosa were identified over a 3-year period from seven tertiary care hospitals. Patients with recurrent BSI were identified. Extensive epidemiological, clinical and outcome data were obtained. BSI recurrence was found to be uncommon with 9% of patients having a first relapse of BSI. Fourteen percent of these patients went on to have a second relapse of BSI. Significant variables associated with recurrence were the presence of a hematological malignancy or receiving recent corticosteroid therapy. Exposure to anti-pseudomonal beta-lactam therapy in the 30days prior to the BSI was more likely in the patient with the recurrent BSI episode. Recurrence was associated with increased mortality when compared to the primary BSI episode. Knowledge of a patient's prior antibiotic therapy may be useful in ensuring effective empirical therapy in the recurrent BSI episode.