Examination of Changes in Risk Factors for Mortality and Antimicrobial Resistance in Pseudomonas species Infections in Solid-Organ Transplant Patients Over the Years.

Abstract

Objectives: Although Pseudomonas species infections have decreased since the introduction of anti -pseudomonal antibiotics, these infections still cause mortality in immunocompromised patients. This study investigated the antibiotic resistance and mortality risk factors of Pseudomonas species isolated from various materials in solid -organ transplant recipients.

Materials and methods: Infections due to Pseudomonas species between 2020 and 2024 were retrospectively analyzed in solid -organ transplant recipients aged >18 years. Recurrent infections in the same patient were excluded. We analyzed resistance profiles to commonly used antibiotics, demographic and laboratory data, and risk factors affecting 30 -day hospital mortality using the SPSS version 25 statistical program.

Results: Pseudomonas species infection was detected in 80 solid -organ transplant recipients: 70 % were male patients, 78 % had living donors, and 57 % were kidney transplant recipients. Pseudomonas aeruginosa was the most frequently detected species (95 % ). The most common agent was detected in body fluid samples. Thirty -day hospital mortality was 18.8 %. Mortality was significantly higher in patients with resistance to amikacin, ciprofloxacin, cefepime, and colistin, and in those with invasive procedures and mechanical ventilation, and in patients with sepsis and in intensive care. Resistance rates were higher between 2020 and 2023, when the COVID -19 pandemic was active.

Conclusions: Although changes occurred over the years, antibiotic resistance increased during the COVID -19 pandemic. This increased resistance created difficulties in empirical and pathogen -targeted treatments. Amikacin and colistin are recommended for empirical treatment of Pseudomonas species infections due to their low resistance rates. In addition, unnecessary invasive procedures should be avoided, discontinuing them when the indication is no longer there. Adhering to infection prevention can reduce risk factors, as sepsis, intensive care unit stay, and invasive procedures affect mortality.