Dissecting bloodstream infections in febrile neutropenic patients with hematological malignancies, a decade-long single center retrospective observational study (2009-2019).

Autor:	El Omri H; Division of Hematology, Department of Medical Oncology, National Center for Cancer Care & Research (NCCCR), Hamad Medical Corporation (HMC), Doha 3050, Qatar., Padmanabhan R; College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha 34110, Qatar., Taha RY; Division of Hematology, Department of Medical Oncology, National Center for Cancer Care & Research (NCCCR), Hamad Medical Corporation (HMC), Doha 3050, Qatar., Kassem N; Pharmacy Department NCCCR, Hamad Medical Corporation, Doha, Qatar., Elsabah H; Division of Hematology, Department of Medical Oncology, National Center for Cancer Care & Research (NCCCR), Hamad Medical Corporation (HMC), Doha 3050, Qatar., Ellahie AY; Division of Hematology, Department of Medical Oncology, National Center for Cancer Care & Research (NCCCR), Hamad Medical Corporation (HMC), Doha 3050, Qatar., Santimano AJJ; Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha 3050, Qatar., Al-Maslamani MA; Communicable Disease Center, Hamad Medical Corporation, Qatar., Omrani AS; Communicable Disease Center, Hamad Medical Corporation, Qatar., Elomri A; College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha 34110, Qatar., El Omri A; Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha 3050, Qatar. Electronic address: AElOmri@hamad.qa.
Jazyk:	angličtina
Zdroj:	Journal of infection and public health [J Infect Public Health] 2024 Jan; Vol. 17 (1), pp. 152-162. Date of Electronic Publication: 2023 Nov 21.
DOI:	10.1016/j.jiph.2023.11.017
Abstrakt:	Background: The use of ill-suited antibiotics is a significant risk factor behind the increase in the mortality, morbidity, and economic burden for patients who are under treatment for hematological malignancy (HM) and bloodstream infections (BSI). Such unfitting treatment choices intensify the evolution of resistant variants which is a public health concern due to possible healthcare-associated infection spread to the general population. Hence, this study aims to evaluate antibiograms of patients with BSI and risk factors associated with septicemia. Methods: A total of 1166 febrile neutropenia episodes (FNE) among 513 patients with HM from the National Center for Cancer Care and Research (NCCCR), Qatar, during 2009-2019 were used for this study. The socio-demographic, clinical, microbial, and anti-microbial data retrieved from the patient's health records were used. Results: We analyzed the sensitivity of gram-negative and gram-positive bacilli reported in HM-FN-BSI patients. Out of the total 512 microorganisms isolated, 416 (81%) were gram-negative bacteria (GNB), 76 (15%) were gram-positive bacteria (GPB) and 20 (4%) were fungi. Furthermore, in 416 GNB, 298 (71.6%) were Enterobacteriaceae sp. among which 121 (41%) were ESBL (Extended Spectrum Beta-Lactamase) resistant to Cephalosporine third generation and Piperacillin-Tazobactam, 54 (18%) were Carbapenem-resistant or multidrug-resistant organism (MDRO). It's noteworthy that the predominant infectious agents in our hospital include E. coli, Klebsiella species, and P. aeruginosa. Throughout the study period, the mortality rate due to BSI was 23%. Risk factors that show a significant correlation with death are age, disease status, mono or polymicrobial BSI and septic shock. Conclusion: Decision pertaining to the usage of antimicrobials for HM-FN-BSI patients is a critical task that relies on the latest pattern of prevalence, treatment resistance, and clinical outcomes. Analysis of the antibiogram of HM-FN-BSI patients in Qatar calls for a reconsideration of currently followed empirical antibiotic therapy towards better infection control and antimicrobial stewardship. Competing Interests: Declaration of Competing Interest Authors declare no conflict of interest. (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu