Fluoroquinolone treatment as a protective factor for 10-day mortality in Streptococcus pneumoniae bacteremia in cancer patients.

Autor: Fontana NS; Instituto do Câncer do Estado de São Paulo da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. naihmasf@gmail.com.; Departamento de Moléstias Infecciosas e Parasitarias da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. naihmasf@gmail.com.; Rua Pandiá Calógeras, 445, Jardim Vergueiro, Sorocaba, São Paulo, CEP 18030030, Brazil. naihmasf@gmail.com., Ibrahim KY; Instituto do Câncer do Estado de São Paulo da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil., Bonazzi PR; Instituto do Câncer do Estado de São Paulo da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil., Rossi F; Divisão de Laboratório Central do Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil., Almeida SCG; Laboratório Nacional Para Meningites e Infecções Pneumocócicas do Instituto Adolfo Lutz, São Paulo, Brazil., Tengan FM; Departamento de Moléstias Infecciosas e Parasitarias da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil., Brandileone MCC; Laboratório Nacional Para Meningites e Infecções Pneumocócicas do Instituto Adolfo Lutz, São Paulo, Brazil., Abdala E; Instituto do Câncer do Estado de São Paulo da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.; Departamento de Moléstias Infecciosas e Parasitarias da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2021 Feb 12; Vol. 11 (1), pp. 3699. Date of Electronic Publication: 2021 Feb 12.
DOI: 10.1038/s41598-021-81415-0
Abstrakt: To evaluate the prognostic factors in adult cancer patients with pneumococcal bacteremia, describe episode features and the phenotypic characteristics of the isolated strains. We evaluated the episodes in patients admitted to a cancer hospital between 2009 and 2015. The outcomes were defined as 48 h mortality and mortality within 10 days after the episode. The variables evaluated were: age, sex, ethnicity, ECOG, Karnofsky score, SOFA, cancer type, metastasis, chemotherapy, radiotherapy, neutropenia, previous antibiotic therapy, community or healthcare-acquired infection, comorbidities, smoking, pneumococcal vaccination, infection site, presence of fever, polymicrobial infection, antimicrobial susceptibility, serotype and treatment. 165 episodes were detected in 161 patients. The mean age was 61.3 years; solid tumors were the most prevalent (75%). 48 h and 10-day mortality were 21% (34/161) and 43% (70/161) respectively. The 48 h mortality- associated risk factors were SOFA and polymicrobial bacteremia; 10-day mortality-associated risk factors were fever, neutropenia, ECOG 3/4, SOFA and fluoroquinolones as a protective factor. Pneumococcal bacteremia presented high mortality in cancer patients, with prognosis related to intrinsic host factors and infection episodes features. Fluoroquinolone treatment, a protective factor in 10-day mortality, has potential use for IPDs and severe community-acquired pneumonia in cancer patients.
Databáze: MEDLINE
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