We conducted a retrospective cohort study to identify risk factors for mortality in a large cohort of hematologic patients with bacteremia. From 2000 through 2005, bacteremia was diagnosed in 217 patients with hematologic malignancies. The infections were caused only by Gram-positive organisms in 57.1% (124/217) cases and only by Gram-negative bacteria in 37.8% (82/217); the remaining 5.1% (11/217) were polymicrobial. The overall 30-day mortality rate was 20.3% (44/217). In multivariate analysis, significant predictors of mortality were prolonged neutropenia (P b 0.001), acute renal failure (P = 0.002), nosocomial bacteremia (P = 0.009), age N55 years (P = 0.007), and monomicrobial bacteremia due to antibiotic-resistant Gram-negative bacteria (P = 0.009). Reducing fatal outcomes associated with bacteremia in patients with hematologic malignancies is a challenge, and the emergence of resistance to the antimicrobials widely used in this setting is of great concern. Future infection trends must be carefully monitored and treatment guidelines adjusted accordingly.

Tumbarello, M., Spanu, T., Caira, M., Trecarichi, E. M., Laurenti, L., Montuori, E. A., Fianchi, L., Leone, F., Fadda, G., Cauda, R., Pagano, L., Factors associated with mortality in bacteremic patients with hematologic malignancies., <<DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE>>, 2009; 64 (3): 320-326 [http://hdl.handle.net/10807/6062]

Factors associated with mortality in bacteremic patients with hematologic malignancies.

Tumbarello, Mario;Spanu, Teresa;Caira, Morena;Trecarichi, Enrico Maria;Laurenti, Luca;Montuori, Eva Agostina;Fianchi, Luana;Leone, Fiammetta;Fadda, Giovanni;Cauda, Roberto;Pagano, Livio
2009

Abstract

We conducted a retrospective cohort study to identify risk factors for mortality in a large cohort of hematologic patients with bacteremia. From 2000 through 2005, bacteremia was diagnosed in 217 patients with hematologic malignancies. The infections were caused only by Gram-positive organisms in 57.1% (124/217) cases and only by Gram-negative bacteria in 37.8% (82/217); the remaining 5.1% (11/217) were polymicrobial. The overall 30-day mortality rate was 20.3% (44/217). In multivariate analysis, significant predictors of mortality were prolonged neutropenia (P b 0.001), acute renal failure (P = 0.002), nosocomial bacteremia (P = 0.009), age N55 years (P = 0.007), and monomicrobial bacteremia due to antibiotic-resistant Gram-negative bacteria (P = 0.009). Reducing fatal outcomes associated with bacteremia in patients with hematologic malignancies is a challenge, and the emergence of resistance to the antimicrobials widely used in this setting is of great concern. Future infection trends must be carefully monitored and treatment guidelines adjusted accordingly.
Inglese
Tumbarello, M., Spanu, T., Caira, M., Trecarichi, E. M., Laurenti, L., Montuori, E. A., Fianchi, L., Leone, F., Fadda, G., Cauda, R., Pagano, L., Factors associated with mortality in bacteremic patients with hematologic malignancies., <<DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE>>, 2009; 64 (3): 320-326 [http://hdl.handle.net/10807/6062]
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10807/6062
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