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Abstract

Impact of Hypoalbuminemia in Patients with Pseudomonas Aeruginosa Bloodstream Infections: a Retrospective Cohort Study by Hongying Zhu, Xueyao Fang, Longhua Hu, Qiaoshi Zhong, Hong Luo, Shumin Gu, Junqi Zhu, Liqin Zhang, Shuhui Zou, Jun Liang, Suqin Peng, Yuhui Xu

Background: Hypoalbuminemia is associated with poor outcomes in patients with infectious diseases. We aimed to determine the effect of hypoalbuminemia on treatment failure in adult patients with P. aeruginosa bloodstream infections.
Methods: This retrospective cohort study included adults with microbiologically and clinically documented bloodstream infections caused by P. aeruginosa between January 2012 and December 2021. Hypoalbuminemia was de-fined as baseline serum albumin level < 35 g/L. The main clinical outcomes were treatment failure, 14-day and 30-day mortality, length of hospital stay, and intensive care unit admission.
Results: Out of 207 patients included in the 10-year study period, 145 (70.0%) presented with hypoalbuminemia. Hypoalbuminemia patients were more likely to receive mechanical ventilation (20.0% vs. 4.8%, p = 0.006) and have a higher treatment failure rate (32.9% vs. 12.9%, p = 0.003) compared to normoalbuminemia patients. Multivariate analyses showed that hypoalbuminemia, glucocorticoid use, and Pitt score ≥ 2 are associated with treatment failure (p < 0.05).
Conclusions: Glucocorticoid use, hypoalbuminemia, and Pitt score ≥ 2 points were more frequent in patients with P. aeruginosa bloodstream infections and were associated with poor outcomes. Therefore, P. aeruginosa bloodstream infections patients may benefit from early replenish albumin molecules.

DOI: 10.7754/Clin.Lab.2025.250303