Please use this identifier to cite or link to this item:
http://hdl.handle.net/2445/190781
Title: | Pseudomonas aeruginosa Bloodstream Infections in Patients with Cancer: Differences between Patients with Hematological Malignancies and Solid Tumors |
Author: | Royo Cebrecos, Cristina Laporte Amargós, Julia Peña, Marta Ruiz, Isabel (Ruiz Camps) Puerta Alcalde, Pedro Abdala, Edson Oltolini, Chiara Akova, Murat Montejo, Miguel Mikulska, Malgorzata Martín Dávila, Pilar Herrera, Fabián Gasch, Oriol Drgona, Lubos Morales, Hugo Manuel Paz Brunel, Anne Sophie García, Estefanía Isler, Burcu Kern, Winfried V. Palacios Baena, Zaira R. De La Calle, Guillermo Maestro Montero, Maria Milagro Kanj, Souha S. Sipahi, Oguz R. Calik, Sebnem Márquez Gómez, Ignacio Marin, Jorge I. Gomes, Marisa Z. R. Hemmatti, Philipp Araos, Rafael Peghin, Maddalena Del Pozo, José Luis Yáñez, Lucrecia Tilley, Robert Manzur, Adriana Novo, Andrés Carratalà, Jordi Gudiol González, Carlota |
Keywords: | Càncer Tumors Cancer Tumors |
Issue Date: | 30-Sep-2022 |
Publisher: | MDPI AG |
Abstract: | Objectives: To assess the clinical features and outcomes of Pseudomonas aeruginosa bloodstream infection (PA BSI) in neutropenic patients with hematological malignancies (HM) and with solid tumors (ST), and identify the risk factors for 30-day mortality. Methods: We performed a large multicenter, retrospective cohort study including onco-hematological neutropenic patients with PA BSI conducted across 34 centers in 12 countries (January 2006-May 2018). Episodes occurring in hematologic patients were compared to those developing in patients with ST. Risk factors associated with 30-day mortality were investigated in both groups. Results: Of 1217 episodes of PA BSI, 917 occurred in patients with HM and 300 in patients with ST. Hematological patients had more commonly profound neutropenia (0.1 x 10(9) cells/mm) (67% vs. 44.6%; p < 0.001), and a high risk Multinational Association for Supportive Care in Cancer (MASCC) index score (32.2% vs. 26.7%; p = 0.05). Catheter-infection (10.7% vs. 4.7%; p = 0.001), mucositis (2.4% vs. 0.7%; p = 0.042), and perianal infection (3.6% vs. 0.3%; p = 0.001) predominated as BSI sources in the hematological patients, whereas pneumonia (22.9% vs. 33.7%; p < 0.001) and other abdominal sites (2.8% vs. 6.3%; p = 0.006) were more common in patients with ST. Hematological patients had more frequent BSI due to multidrug-resistant P. aeruginosa (MDRPA) (23.2% vs. 7.7%; p < 0.001), and were more likely to receive inadequate initial antibiotic therapy (IEAT) (20.1% vs. 12%; p < 0.001). Patients with ST presented more frequently with septic shock (45.8% vs. 30%; p < 0.001), and presented worse outcomes, with increased 7-day (38% vs. 24.2%; p < 0.001) and 30-day (49% vs. 37.3%; p < 0.001) case-fatality rates. Risk factors for 30-day mortality in hematologic patients were high risk MASCC index score, IEAT, pneumonia, infection due to MDRPA, and septic shock. Risk factors for 30-day mortality in patients with ST were high risk MASCC index score, IEAT, persistent BSI, and septic shock. Therapy with granulocyte colony-stimulating factor was associated with survival in both groups. Conclusions: The clinical features and outcomes of PA BSI in neutropenic cancer patients showed some differences depending on the underlying malignancy. Considering these differences and the risk factors for mortality may be useful to optimize their therapeutic management. Among the risk factors associated with overall mortality, IEAT and the administration of granulocyte colony-stimulating factor were the only modifiable variables. |
Note: | Reproducció del document publicat a: https://doi.org/10.3390/pathogens11101132 |
It is part of: | Pathogens, 2022, vol. 11, issue. 10, p. 1132 |
URI: | http://hdl.handle.net/2445/190781 |
Related resource: | https://doi.org/10.3390/pathogens11101132 |
ISSN: | 2076-0817 |
Appears in Collections: | Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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