Pseudomonas aeruginosa Bloodstream Infections in Patients with Cancer: Differences between Patients with Hematological Malignancies and Solid Tumors.

Autor:	Royo-Cebrecos C; Internal Medicine Department, Hospital Nostra Senyora de Meritxell, Andorra Health Services (SAAS), AD700 Escaldes-Engordany, Andorra., Laporte-Amargós J; Infectious Diseases Department, Bellvitge University Hospital, IDIBELL, University of Barcelona, 08907 Barcelona, Spain.; Institut Català d'Oncologia (ICO), Hospital Duran i Reynals, IDIBELL, 08907 Barcelona, Spain., Peña M; Hematology Department, Institut Català d'Oncologia (ICO)-Hospital Duran i Reynals, IDIBELL, 08907 Barcelona, Spain., Ruiz-Camps I; Infectious Diseases Department, Vall d'Hebron University Hospital, 08035 Barcelona, Spain., Puerta-Alcalde P; Infectious Diseases Department, Hospital Clínic i Provincial, 08035 Barcelona, Spain., Abdala E; Instituto do Câncer do Estado de São Paulo, Faculty of Medicine, Univesity of São Paulo, Sao Paulo 01246, Brazil., Oltolini C; Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy., Akova M; Department of Infectious Diseases, Hacettepe University School of Medicine, 06230 Ankara, Turkey., Montejo M; Infectious Diseases Unit, Cruces University Hospital, 48903 Bilbao, Spain., Mikulska M; Division of Infectious Diseases, University of Genoa (DISSAL) and Ospedale Policlinico San Martino, 16132 Genoa, Italy., Martín-Dávila P; Infectious Diseases Department, Ramon y Cajal Hospital, 28034 Madrid, Spain., Herrera F; Infectious Diseases Section, Department of Medicine, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires C1430EFA, Argentina., Gasch O; Infectious Diseases Department, Parc Taulí University Hospital, 08208 Sabadell, Spain., Drgona L; Oncohematology Department, Comenius University and National Cancer Institute, 81499 Bratislava, Slovakia., Morales HMP; Infectious Diseases Department, Hospital Erasto Gaertner, Curitiba 81520-060, Brazil., Brunel AS; Infectious Diseases Department, Department of Medicine, Lausanne University Hospital, (CHUV), 1011 Lausanne, Switzerland., García E; Hematology Department, Reina Sofía University Hospital-IMIBIC-UCO, Córdoba 14004, Argentina., Isler B; Department of Infectious Diseases and Clinical Microbiology, Istanbul Education and Research Hospital, 34668 Istanbul, Turkey., Kern WV; Division of Infectious Diseases, Department of Medicine II, University of Freiburg Medical Center and Faculty of Medicine, 79106 Freiburg, Germany., Palacios-Baena ZR; Unit of Infectious Diseases and Clinical Microbiology, Virgen Macarena University Hospital, Institute of Biomedicine of Seville (IBIS), 41013 Seville, Spain., de la Calle GM; Infectious Diseases Unit, Instituto de Investigación Hospital '12 de Octubre' (i+12), '12 de Octubre', University Hospital, School of Medicine, Universidad Complutense, 28041 Madrid, Spain., Montero MM; Infectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigations Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, 08003 Barcelona, Spain., Kanj SS; Infectious Diseases Division, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon., Sipahi OR; Faculty of Medicine, Ege University, 35040 Izmir, Turkey., Calik S; University of Health Science Izmir Bozyaka Training and Research Hospital, 35170 Izmir, Turkey., Márquez-Gómez I; Infectious Diseases Department, Hospital Regional de Málaga, 29010 Málaga, Spain., Marin JI; Infectious Diseases and Clinical Microbiology Department, Clínica Maraya, Pereira, Colombia. Critical Care and Clinical Microbiology Department, Manizales 170001-17, Colombia., Gomes MZR; Hospital Federal dos Servidores do Estado, and Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Ministério da Saúde, Rio de Janeiro 20221-161, Brazil., Hemmatti P; Department of Hematology, Oncology and Palliative Care, Klinikum Ernst von Bergmann, Academic Teaching Hospital, Charité University Medical School, 10117 Berlin, Germany., Araos R; Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago de Chile 12461, Chile, and Millennium Initiative for Collaborative Research on Bacterial Resistance (MICROB-R)., Peghin M; Infectious Diseases Clinic, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Integrata in Udine, and Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, 33100 Udine, Italy., Del Pozo JL; Infectious Diseases and Microbiology Unit, Navarra University Clinic, 31008 Pamplona, Spain., Yáñez L; Hematology Department, Marqués de Valdecilla University Hospital, 39008 Santander, Spain., Tilley R; Microbiology Department, University Hospitals Plymouth NHS Trust, Plymouth PL6 8DH, UK., Manzur A; Infectious Diseases, Hospital Rawson, San Juan J5400, Argentina., Novo A; Hematology Department, Son Espases University Hospital, 07120 Palma de Mallorca, Spain., Carratalà J; Infectious Diseases Department, Bellvitge University Hospital, IDIBELL, University of Barcelona, 08907 Barcelona, Spain.; University of Barcelona, 08007 Barcelona, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain., Gudiol C; Infectious Diseases Department, Bellvitge University Hospital, IDIBELL, University of Barcelona, 08907 Barcelona, Spain.; Institut Català d'Oncologia (ICO), Hospital Duran i Reynals, IDIBELL, 08907 Barcelona, Spain.; University of Barcelona, 08007 Barcelona, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain.
Jazyk:	angličtina
Zdroj:	Pathogens (Basel, Switzerland) [Pathogens] 2022 Sep 30; Vol. 11 (10). Date of Electronic Publication: 2022 Sep 30.
DOI:	10.3390/pathogens11101132
Abstrakt:	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 × 109 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.
Databáze:	MEDLINE
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