Mar Marin1, Carlota Gudiol2, Carmen Ardanuy3, Carol Garcia-Vidal2, Mariona Calvo4, Montserrat Arnan5, Jordi Carratalà2. 1. Oncology Department, ICO (Institut Català d'Oncologia) l'Hospitalet, ICO Duran i Reynals, University of Barcelona, Barcelona, Spain. Electronic address: mmarin@iconcologia.net. 2. Infectious Disease Service, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Hospital Universitari de Bellvitge, University of Barcelona, Spain; REIPI (Spanish Network for Research in Infectious Disease), Instituto de Salud Carlos III, Madrid, Spain. 3. Microbiology Department, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Hospital Universitari de Bellvitge, University of Barcelona, Spain; CIBERes (Centro de Investigación Biomédica en Red en Enfermedades Respiratorias), Instituto de Salud Carlos III, Spain. 4. Oncology Department, ICO (Institut Català d'Oncologia) l'Hospitalet, ICO Duran i Reynals, University of Barcelona, Barcelona, Spain. 5. Haematology Department, ICO (Institut Català d'Oncologia) l'Hospitalet, ICO Duran i Reynals, Barcelona, Spain; Institut d'InvestigacióBiomèdica de Bellvitge (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
Abstract
OBJECTIVES: We sought to identify the characteristics, aetiology, antibiotic resistance and outcomes of bloodstream infection (BSI) in neutropenic patients with haematological malignancies (HM) and in those with solid tumours (ST) and assess their impact on empirical therapy and outcomes. METHODS: All episodes of BSI in neutropenic patients with HM and ST were prospectively recorded and compared. RESULTS: Of 579 episodes of BSI, 493 occurred in patients with HM and 86 in patients with ST. An endogenous source and catheter-related infection were more frequent in patients with HM, whereas pneumonia and urinary tract were more common in the ST group. BSI was mainly due to Gram-negative bacilli. Coagulase-negative staphylococci were more frequent in patients with HM, while Pseudomonas aeruginosa was more common in patients with ST and was the leading cause of pneumonia. Multidrug-resistant Gram-negative bacilli (MDRGNB) were more frequently isolated in haematological patients who more often received inadequate empirical therapy than those with ST. Case-fatality rates were higher in patients with ST. CONCLUSIONS: We identified significant differences in BSI in neutropenic patients with HM and ST. MDRGNB were more often isolated in patients with HM. Pneumonia due to P. aeruginosa was particularly frequent among patients with ST. Case-fatality rates were higher in patients with ST.
OBJECTIVES: We sought to identify the characteristics, aetiology, antibiotic resistance and outcomes of bloodstream infection (BSI) in neutropenicpatients with haematological malignancies (HM) and in those with solid tumours (ST) and assess their impact on empirical therapy and outcomes. METHODS: All episodes of BSI in neutropenicpatients with HM and ST were prospectively recorded and compared. RESULTS: Of 579 episodes of BSI, 493 occurred in patients with HM and 86 in patients with ST. An endogenous source and catheter-related infection were more frequent in patients with HM, whereas pneumonia and urinary tract were more common in the ST group. BSI was mainly due to Gram-negative bacilli. Coagulase-negative staphylococci were more frequent in patients with HM, while Pseudomonas aeruginosa was more common in patients with ST and was the leading cause of pneumonia. Multidrug-resistant Gram-negative bacilli (MDRGNB) were more frequently isolated in haematological patients who more often received inadequate empirical therapy than those with ST. Case-fatality rates were higher in patients with ST. CONCLUSIONS: We identified significant differences in BSI in neutropenicpatients with HM and ST. MDRGNB were more often isolated in patients with HM. Pneumonia due to P. aeruginosa was particularly frequent among patients with ST. Case-fatality rates were higher in patients with ST.
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