OBJECTIVES: The aim of this study was to more precisely delineate the characteristics and outcomes of bloodstream infections in adult cancer patients. METHODS: Using a database for nationwide surveillance of bacteremia, we analyzed data related to bacteremia in adult patients with cancer in order to evaluate clinical features and outcomes and to define predictive factors for mortality. RESULTS: Of 1,246 patients, 896 (71.9%) had solid tumors, 328 (26.3%) had hematologic malignancies, and 22 (1.8%) had both. The following conditions were more common in the neutropenic group than in the non-neutropenic group: nosocomial acquisition, hematologic malignancy, corticosteroid use, immunosuppressant use, primary bacteremia, and pneumonia (all P < 0.05). The infections were caused by Gram-negative bacilli in 55.6% and by Gram-positive cocci in 32.7%. Gram-negative pathogens were more frequently isolated from neutropenic patients than from non-neutropenic patients (61.9% vs. 53.5%, P = 0.010), with a significant predominance of Escherichia coli and Klebsiella pneumoniae. Among 1,001 patients whose outcomes could be evaluated, the overall 30-day mortality rate was 24.1%, and multivariate analysis showed that Staphylococcus aureus bacteremia was a significant factor associated with mortality (odds ratio (OR), 1.80; 95% confidence interval (CI), 1.03-3.15), along with nosocomial acquisition, pneumonia, severe sepsis or septic shock, and higher Pitt bacteremia score (all P values <0.05). CONCLUSION: This study represents the comprehensive assessment of bloodstream infections in neutropenic versus non-neutropenic cancer patients. Given the pathogenic significance of S. aureus bacteremia in adult patients with cancer, additional strategies for the management of S. aureus bacteremia in cancer patients are needed to improve outcomes.
OBJECTIVES: The aim of this study was to more precisely delineate the characteristics and outcomes of bloodstream infections in adult cancerpatients. METHODS: Using a database for nationwide surveillance of bacteremia, we analyzed data related to bacteremia in adult patients with cancer in order to evaluate clinical features and outcomes and to define predictive factors for mortality. RESULTS: Of 1,246 patients, 896 (71.9%) had solid tumors, 328 (26.3%) had hematologic malignancies, and 22 (1.8%) had both. The following conditions were more common in the neutropenic group than in the non-neutropenic group: nosocomial acquisition, hematologic malignancy, corticosteroid use, immunosuppressant use, primary bacteremia, and pneumonia (all P < 0.05). The infections were caused by Gram-negative bacilli in 55.6% and by Gram-positive cocci in 32.7%. Gram-negative pathogens were more frequently isolated from neutropenicpatients than from non-neutropenicpatients (61.9% vs. 53.5%, P = 0.010), with a significant predominance of Escherichia coli and Klebsiella pneumoniae. Among 1,001 patients whose outcomes could be evaluated, the overall 30-day mortality rate was 24.1%, and multivariate analysis showed that Staphylococcus aureus bacteremia was a significant factor associated with mortality (odds ratio (OR), 1.80; 95% confidence interval (CI), 1.03-3.15), along with nosocomial acquisition, pneumonia, severe sepsis or septic shock, and higher Pitt bacteremia score (all P values <0.05). CONCLUSION: This study represents the comprehensive assessment of bloodstream infections in neutropenic versus non-neutropenic cancerpatients. Given the pathogenic significance of S. aureus bacteremia in adult patients with cancer, additional strategies for the management of S. aureus bacteremia in cancerpatients are needed to improve outcomes.
Authors: A Safdar; G H Rodriguez; M Balakrishnan; J J Tarrand; K V I Rolston Journal: Eur J Clin Microbiol Infect Dis Date: 2006-08 Impact factor: 3.267
Authors: Emily P Hyle; Adam D Lipworth; Theoklis E Zaoutis; Irving Nachamkin; Warren B Bilker; Ebbing Lautenbach Journal: Arch Intern Med Date: 2005-06-27
Authors: David L Paterson; Wen-Chien Ko; Anne Von Gottberg; Sunita Mohapatra; Jose Maria Casellas; Herman Goossens; Lutfiye Mulazimoglu; Gordon Trenholme; Keith P Klugman; Robert A Bonomo; Louis B Rice; Marilyn M Wagener; Joseph G McCormack; Victor L Yu Journal: Clin Infect Dis Date: 2004-06-08 Impact factor: 9.079
Authors: J Klastersky; L Ameye; J Maertens; A Georgala; F Muanza; M Aoun; A Ferrant; B Rapoport; K Rolston; M Paesmans Journal: Int J Antimicrob Agents Date: 2007-08-08 Impact factor: 5.283
Authors: Ram Venkatesh Anantha; Januvi Jegatheswaran; Daniel Luke Pepe; Fran Priestap; Johan Delport; S M Mansour Haeryfar; John K McCormick; Tina Mele Journal: CMAJ Open Date: 2014-10-01
Authors: D Averbuch; C Avaky; M Harit; P Stepensky; I Fried; T Ben-Ami; V Temper; Y Peled; H Troen; R Masarwa; W Abu Ahmad; M Weintraub; S Revel-Vilk; D Engelhard Journal: Infection Date: 2017-02-15 Impact factor: 3.553
Authors: E Montassier; E Batard; T Gastinne; G Potel; M F de La Cochetière Journal: Eur J Clin Microbiol Infect Dis Date: 2013-01-25 Impact factor: 3.267
Authors: Kristian Hastoft Jensen; Ivan Vogelius; Claus Ernst Moser; Elo Andersen; Jesper Grau Eriksen; Jørgen Johansen; Mohammad Farhadi; Maria Andersen; Jens Overgaard; Jeppe Friborg Journal: Br J Cancer Date: 2021-05-20 Impact factor: 7.640
Authors: Colum P Dunne; Phelim Ryan; Roisin Connolly; Suzanne S Dunne; Mohammed A Kaballo; James Powell; Bernie Woulfe; Nuala H O'Connell; Rajnish K Gupta Journal: Infect Prev Pract Date: 2020-02-01