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Profiling of bacterial bloodstream infections in hematological and oncological patients based on a comparative survival analysis.
- Source :
-
Annals of Hematology . Jun2021, Vol. 100 Issue 6, p1593-1602. 10p. - Publication Year :
- 2021
-
Abstract
- Bloodstream infections (BSI) are a frequent complication in patients with hematological and oncological diseases. However, the impact of different bacterial species causing BSI and of multiple BSI remains incompletely understood. We performed a retrospective study profiling 637 bacterial BSI episodes in hematological and oncological patients. Based on the 30-day (30d) overall survival (OS), we analyzed different types of multiple BSI and grouped BSI-associated bacteria into clusters followed by further assessment of clinical and infection-related characteristics. We discovered that polymicrobial BSI (different organisms on the first day of a BSI episode) and sequential BSI (another BSI before the respective BSI episode) were associated with a worse 30d OS. Different bacterial groups could be classified into three BSI outcome clusters based on 30d OS: favorable (FAV) including mainly common skin contaminants, Escherichia spp. and Streptococcus spp.; intermediate (INT) including mainly Enterococcus spp., vancomycin-resistant Enterococcus spp., and multidrug-resistant gram-negative bacteria (MDRGN); and adverse (ADV) including MDRGN with an additional carbapenem-resistance (MDRGN+CR). A polymicrobial or sequential BSI especially influenced the outcome in the combination of two INT cluster BSI. The presence of a polymicrobial BSI and the assignment into the BSI outcome clusters were identified as independent risk factors for 30d mortality in a Cox multivariate regression analysis. The assignment to a BSI outcome cluster and the differentiated perspective of multiple BSI open new insights into the prognosis of patients with BSI and should be further validated in other patient cohorts. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ENTEROCOCCUS
*SURVIVAL analysis (Biometry)
*BACTERIAL diseases
*OVERALL survival
*ACINETOBACTER infections
*GRAM-negative bacteria
*COMPARATIVE studies
*ENTEROCOCCAL infections
*ANTIBIOTICS
*BACTEREMIA
*RESEARCH
*RESEARCH methodology
*RETROSPECTIVE studies
*MEDICAL cooperation
*EVALUATION research
*BLOOD diseases
*HEMATOLOGIC malignancies
*IMPACT of Event Scale
*BRIEF Symptom Inventory
*BACTERIA
*PROPORTIONAL hazards models
*DISEASE complications
Subjects
Details
- Language :
- English
- ISSN :
- 09395555
- Volume :
- 100
- Issue :
- 6
- Database :
- Academic Search Index
- Journal :
- Annals of Hematology
- Publication Type :
- Academic Journal
- Accession number :
- 150302164
- Full Text :
- https://doi.org/10.1007/s00277-021-04541-9