Predictors of Mortality in Pseudomonas aeruginosa Bloodstream Infections: A Scoping Review

TL;DR

This review summarizes mortality rates and risk factors for Pseudomonas aeruginosa bloodstream infections, highlighting key predictors and gaps in post-pandemic research.

Contribution

The study provides a scoping review of recent literature on PABSIs, identifying consistent mortality predictors and highlighting research gaps.

Findings

Mortality rates varied, but predictors like carbapenem exposure and sepsis were consistently identified.

Few studies linked molecular mechanisms to outcomes, showing a gap in understanding.

Critically ill and immunocompromised patients remain at highest risk for death from PABSIs.

Abstract

Pseudomonas aeruginosa bloodstream infections (PABSIs) are a major clinical challenge due to their association with significant mortality and antimicrobial resistance mechanisms. The COVID-19 pandemic changed antimicrobial practices, intensive care management, and patient risk profiles, potentially influencing the epidemiology and outcomes of PABSIs. In the post-pandemic period, practices were expected to revert to normal. The objective of this scoping review was to identify and summarize reported mortality rates and risk factors for PABSIs in studies published between 2023 and 2025. Literature searches were conducted across PubMed, Web of Science, Embase, and Scopus. Screening was performed in accordance with PRISMA-ScR guidelines. Twenty-two eligible studies were included. Mortality rates varied across the study setting and populations; however, several consistent predictors were consistently identified, including carbapenem exposure, multidrug-resistant Pseudomonas aeruginosa, hematologic disease or malignancy, corticosteroid therapy, sepsis or septic shock, mechanical ventilation, and higher severity-of-illness scores. Few studies have linked molecular mechanisms to patient outcomes, highlighting important gaps in knowledge. Notably, only a small number of studies included the post-pandemic period but did not analyze the data separately. Despite limited available evidence, critically ill and immunocompromised patients remain at greatest risk of death from PABSIs. This review highlights the need for a broader comparative analysis in future.

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