Background: Polymicrobial bloodstream infections (pBSI) occurring in hematological patients are still poorly understood, and specific information are very limited. Objectives and methods: In this epidemiologic survey, we describe clinical characteristics and outcome of 125 consecutive pBSI occurred in oncohematological patients. Polymicrobial bloodstream infections (pBSI) were defined with the isolation of 2 or more bacteria from blood culture specimens obtained within 72 h. Results: Over an 11-year period, we documented 500 bacterial bloodstream infections (BSI) in 4542 hospital admissions and 25% (125) of these were pBSI. Most common underlying hematological disease was acute myeloid leukemia and 89% of patients had severe neutropenia. Fifty pBSI (40%) occurred in patients undergoing a stem cell transplantation (SCT), mostly within 30 days from transplant (42/50–84%). Principal bacterial association was Gram-positive plus Gram-negative (57%). Resolution rate of pBSI was 82%, without differences between SCT and non-SCT cases. pBSI-related mortality was 15% (6% in SCT cases). Septic shock occurred in 16% of cases and septic shock–related mortality was 65% (75% in SCT cases and 63% in non-SCT cases; p = 0.6). Multidrug-resistant (MDR) bacteria were involved in 22% of pBSI and the MDR-pBSI–related mortality was significantly higher in SCT patients (p = 0.007). Conclusions: This observational study highlights that pBSI is not a rare bloodstream infectious complication in oncohematological patients. pBSI-related mortality is lower than 20%, but, if septic shock occurs, mortality reaches 65%. MDR bacteria were involved in 22% of cases and pBSI-MDR–related mortality was significantly higher in SCT patients.

Clinical characteristics and outcome of 125 polymicrobial bloodstream infections in hematological patients: an 11-year epidemiologic survey / Facchin, G.; Candoni, A.; Lazzarotto, D.; Zannier, M. E.; Peghin, M.; Sozio, E.; Pellegrini, N.; Fili, C.; Sartor, A.; Tascini, C.; Fanin, R.. - In: SUPPORTIVE CARE IN CANCER. - ISSN 0941-4355. - 30:3(2022), pp. 2359-2366. [10.1007/s00520-021-06640-9]

Clinical characteristics and outcome of 125 polymicrobial bloodstream infections in hematological patients: an 11-year epidemiologic survey

Candoni A.;
2022-01-01

Abstract

Background: Polymicrobial bloodstream infections (pBSI) occurring in hematological patients are still poorly understood, and specific information are very limited. Objectives and methods: In this epidemiologic survey, we describe clinical characteristics and outcome of 125 consecutive pBSI occurred in oncohematological patients. Polymicrobial bloodstream infections (pBSI) were defined with the isolation of 2 or more bacteria from blood culture specimens obtained within 72 h. Results: Over an 11-year period, we documented 500 bacterial bloodstream infections (BSI) in 4542 hospital admissions and 25% (125) of these were pBSI. Most common underlying hematological disease was acute myeloid leukemia and 89% of patients had severe neutropenia. Fifty pBSI (40%) occurred in patients undergoing a stem cell transplantation (SCT), mostly within 30 days from transplant (42/50–84%). Principal bacterial association was Gram-positive plus Gram-negative (57%). Resolution rate of pBSI was 82%, without differences between SCT and non-SCT cases. pBSI-related mortality was 15% (6% in SCT cases). Septic shock occurred in 16% of cases and septic shock–related mortality was 65% (75% in SCT cases and 63% in non-SCT cases; p = 0.6). Multidrug-resistant (MDR) bacteria were involved in 22% of pBSI and the MDR-pBSI–related mortality was significantly higher in SCT patients (p = 0.007). Conclusions: This observational study highlights that pBSI is not a rare bloodstream infectious complication in oncohematological patients. pBSI-related mortality is lower than 20%, but, if septic shock occurs, mortality reaches 65%. MDR bacteria were involved in 22% of cases and pBSI-MDR–related mortality was significantly higher in SCT patients.
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Clinical characteristics and outcome of 125 polymicrobial bloodstream infections in hematological patients: an 11-year epidemiologic survey / Facchin, G.; Candoni, A.; Lazzarotto, D.; Zannier, M. E.; Peghin, M.; Sozio, E.; Pellegrini, N.; Fili, C.; Sartor, A.; Tascini, C.; Fanin, R.. - In: SUPPORTIVE CARE IN CANCER. - ISSN 0941-4355. - 30:3(2022), pp. 2359-2366. [10.1007/s00520-021-06640-9]
Facchin, G.; Candoni, A.; Lazzarotto, D.; Zannier, M. E.; Peghin, M.; Sozio, E.; Pellegrini, N.; Fili, C.; Sartor, A.; Tascini, C.; Fanin, R.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1293942
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