Please use this identifier to cite or link to this item:
http://hdl.handle.net/2445/128531
Title: | Risk factors for mortality in patients with acute leukemia and bloodstream infections in the era of multiresistance |
Author: | Garcia Vidal, Carolina Cardozo Espinola, Celia Puerta-Alcalde, Pedro Marco Reverté, Francesc Tellez, Adrian Agüero, Daiana Romero Santana, Francisco Díaz Beyà, Marina Giné Soca, Eva Morata, Laura Rodríguez Núñez, Olga Martínez, José Antonio Mensa Pueyo, Josep Esteve, Jordi Soriano Viladomiu, Alex |
Keywords: | Leucèmia Mortalitat Leukemia Mortality |
Issue Date: | 28-Jun-2018 |
Publisher: | Public Library of Science (PLoS) |
Abstract: | Objectives: We assess the epidemiology and risk factors for mortality of bloodstream infection (BSI) in patients with acute leukemia (AL). Methods: Prospectively collected data of a cohort study from July 2004 to February 2016. Multivariate analyses were performed. Results: 589 episodes of BSI were documented in 357 AL patients, 55% caused by gram-positive bacteria (coagulase-negative staphylococci 35.7%, Enterococcus spp 10.8%) and 43.5% by gram-negative bacteria (E. coli 21%, PA 12%). We identified 110 (18.7%) multidrug-resistant (MDR) microorganisms, especially MDR-Pseudomonas aeruginosa (7%) and extended-spectrum beta-lactamase producing Enterobacteriaceae (7%). The 30-day mortality was 14.8%. Age (OR 3.1; 95% CI 1.7–5.7); chronic lung disease (4.8; 1.1–21.8); fatal prognosis according to McCabe index (13.9; 6.4–30.3); shock (3.8; 1.9–7.7); pulmonary infection (3.6; 1.3–9.9); and MDR-PA infections with inappropriate treatment (12.8; 4.1–40.5) were related to mortality. MDR-PA BSI was associated to prior antipseudomonal cephalosporin use (9.31; 4.38–19.79); current use of betalactams (2.01; 1.01–4.3); shock (2.63; 1.03–6.7) and pulmonary source of infection (9.6; 3.4–27.21). Conclusions: MDR organisms were commonly isolated in BSI in AL. Inappropriate empiric antibiotic treatment for MDR-PA is the primary factor related to mortality that can be changed. New treatment strategies to improve the coverage of MDR-PA BSI should be considered in those patients with risk factors for this infection. |
Note: | Reproducció del document publicat a: http://dx.doi.org/10.1371/journal.pone.0199531 |
It is part of: | PLoS One, 2018, vol. 13, num. 6, p. e0199531 |
URI: | http://hdl.handle.net/2445/128531 |
Related resource: | http://dx.doi.org/ 10.1371/journal.pone.0199531 |
ISSN: | 1932-6203 |
Appears in Collections: | Articles publicats en revistes (ISGlobal) Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
journal.pone.0199531_MMarcos.pdf | 605.13 kB | Adobe PDF | View/Open |
This item is licensed under a
Creative Commons License