Profiling of bacterial bloodstream infections in hematological and oncological patients based on a comparative survival analysis

  • 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.
Author:Sarah Weber, Aaron Magh, Michael HogardtGND, Volkhard A. J. KempfORCiDGND, Maria J. G. T. VehreschildORCiDGND, Hubert ServeORCiDGND, Sebastian ScheichORCiD, Björn Steffen
Parent Title (English):Annals of hematology
Place of publication:Berlin ; Heidelberg ; New York
Document Type:Article
Date of Publication (online):2021/05/03
Date of first Publication:2021/05/03
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2022/10/20
Tag:Bloodstream infection; Cancer; Cluster; Hematology; Oncology
Page Number:10
First Page:1593
Last Page:1602
Open Access funding enabled and organized by Projekt DEAL. VAJK and MH are partially supported by the University Center of Competence for Infection Control, State of Hesse, Germany, and the Robert Koch-Institute, Germany.
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0