Aarne Kolonen1, Marjatta Sinisalo1, Reetta Huttunen1, Jaana Syrjänen1, Janne Aittoniemi2, Heini Huhtala3, Marja Sankelo1, Hannele Rintala1, Riikka Räty4, Esa Jantunen5, Tapio Nousiainen5, Marjaana Säily6, Marjut Kauppila7,8, Maija Itälä-Remes7,8, Hanna Ollikainen9, Auvo Rauhala10, Pirjo Koistinen6, Erkki Elonen4. 1. a Department of Internal Medicine , Tampere University Hospital , Tampere , Finland. 2. b Fimlab Laboratories , Tampere , Finland. 3. c Faculty of Social Sciences , University of Tampere , Tampere , Finland. 4. d Department of Hematology , Helsinki University Hospital Comprehensive Cancer Center and University of Helsinki, Finland. 5. e Department of Internal Medicine, Kuopio University Hospital , Kuopio , Finland. 6. f Department of Internal Medicine, Oulu University Hospital , Oulu , Finland. 7. g Division of Medicine, Turku University Hospital , Turku , Finland. 8. h Department of Hematology and Stem Cell Transplantation, Turku University Hospital , Turku , Finland. 9. i Department of Hematology, Satakunta Central Hospital , Pori , Finland. 10. j Vaasa Central Hospital , Vaasa , Finland.
Abstract
BACKGROUND: Infections greatly influence the outcome of acute myeloid leukemia (AML) patients receiving intensive treatment. The aim of this study was to establish the incidence, microbial etiology, risk factors and prognosis of bloodstream infections (BSIs) in patients with AML and compare the results with the previous treatment protocol (AML-92). METHODS: Registery data were gathered prospectively from 357 patients aged 16-65 years recruited on the AML-2003 treatment protocol between November 2003 and November 2011 during different treatment cycles. RESULTS: Blood culture data were available on 977 treatment episodes, in which there were 503 BSIs (51%). The overall incidence rate (IR) for BSIs (per 1000 hospital days) was 16.7. Twenty patients (5.6%) died due to an infection and 16 of them (80%) had a BSI. The most commonly detected microbes (polymicrobial episodes included) in blood cultures were coagulase-negative staphylococci (CoNS, 24.7%), viridans group streptococci (VGS, 19.1%), enterococci (13.9%) and Enterobacteriacae group (25.9%). The etiology of BSIs varied greatly from treatment cycle to cycle. CONCLUSIONS: Enterococcal BSIs have increased compared to our previous treatment protocol, and they represent significant pathogens in blood cultures. Infection-related mortality has decreased despite the increase in the IR of BSIs. Enterococci seem to be an increasingly prominent pathogen underlying BSIs in the AML patients, especially during induction therapy (20%).
BACKGROUND:Infections greatly influence the outcome of acute myeloid leukemia (AML) patients receiving intensive treatment. The aim of this study was to establish the incidence, microbial etiology, risk factors and prognosis of bloodstream infections (BSIs) in patients with AML and compare the results with the previous treatment protocol (AML-92). METHODS: Registery data were gathered prospectively from 357 patients aged 16-65 years recruited on the AML-2003 treatment protocol between November 2003 and November 2011 during different treatment cycles. RESULTS: Blood culture data were available on 977 treatment episodes, in which there were 503 BSIs (51%). The overall incidence rate (IR) for BSIs (per 1000 hospital days) was 16.7. Twenty patients (5.6%) died due to an infection and 16 of them (80%) had a BSI. The most commonly detected microbes (polymicrobial episodes included) in blood cultures were coagulase-negative staphylococci (CoNS, 24.7%), viridans group streptococci (VGS, 19.1%), enterococci (13.9%) and Enterobacteriacae group (25.9%). The etiology of BSIs varied greatly from treatment cycle to cycle. CONCLUSIONS: Enterococcal BSIs have increased compared to our previous treatment protocol, and they represent significant pathogens in blood cultures. Infection-related mortality has decreased despite the increase in the IR of BSIs. Enterococci seem to be an increasingly prominent pathogen underlying BSIs in the AMLpatients, especially during induction therapy (20%).
Authors: Frank Daniel Martos-Benítez; Caridad de Dios Soler-Morejón; Karla Ximena Lara-Ponce; Versis Orama-Requejo; Dailé Burgos-Aragüez; Hilev Larrondo-Muguercia; Rahim W Lespoir Journal: World J Clin Oncol Date: 2020-10-24