Cargando…

Characteristics and Outcomes of Bloodstream Infections in a Tertiary-Care Pediatric Hematology–Oncology Unit: A 10-Year Study

Bloodstream infections (BSIs) after chemotherapy or hematopoietic stem cell transplantation (HSCT) are a leading cause of morbidity and mortality. Data on 154 BSIs that occurred in 111 onco-hematological patients (57 hematological malignancies, 28 solid tumors, and 26 non-malignant hematological dis...

Descripción completa

Detalles Bibliográficos
Autores principales: Mattei, Davide, Baretta, Valentina, Mazzariol, Annarita, Maccacaro, Laura, Balter, Rita, Zaccaron, Ada, Bonetti, Elisa, Chinello, Matteo, Vitale, Virginia, Caddeo, Giulia, Esposto, Maria Pia, Pezzella, Vincenza, Gibellini, Davide, Tridello, Gloria, Cesaro, Simone
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8836920/
https://www.ncbi.nlm.nih.gov/pubmed/35160334
http://dx.doi.org/10.3390/jcm11030880
_version_ 1784649796335697920
author Mattei, Davide
Baretta, Valentina
Mazzariol, Annarita
Maccacaro, Laura
Balter, Rita
Zaccaron, Ada
Bonetti, Elisa
Chinello, Matteo
Vitale, Virginia
Caddeo, Giulia
Esposto, Maria Pia
Pezzella, Vincenza
Gibellini, Davide
Tridello, Gloria
Cesaro, Simone
author_facet Mattei, Davide
Baretta, Valentina
Mazzariol, Annarita
Maccacaro, Laura
Balter, Rita
Zaccaron, Ada
Bonetti, Elisa
Chinello, Matteo
Vitale, Virginia
Caddeo, Giulia
Esposto, Maria Pia
Pezzella, Vincenza
Gibellini, Davide
Tridello, Gloria
Cesaro, Simone
author_sort Mattei, Davide
collection PubMed
description Bloodstream infections (BSIs) after chemotherapy or hematopoietic stem cell transplantation (HSCT) are a leading cause of morbidity and mortality. Data on 154 BSIs that occurred in 111 onco-hematological patients (57 hematological malignancies, 28 solid tumors, and 26 non-malignant hematological diseases) were retrospectively collected and analyzed. Monomicrobial Gram-positive (GP), Gram-negative (GN), and fungal BSIs accounted for 50% (77/154), 38.3% (59/144), and 3.2% (5/154) of all episodes. Polymicrobial infections were 7.8% (12/154), while mixed bacterial–fungal infections were 0.6% (1/154). The most frequent GN isolates were Escherichia coli (46.9%), followed by Pseudomonas aeruginosa (21.9%), Klebsiella species (18.8%), and Enterobacter species (6.3%). Overall, 18.8% (12/64) of GN organisms were multidrug-resistant (seven Escherichia coli, three Klebsiella pneumoniae, and two Enterobacter cloacae), whereas GP resistance to glycopeptides was observed in 1% (1/97). Initial empirical antibiotic therapy was deemed inappropriate in 12.3% of BSIs (19/154). The 30-day mortality was 7.1% (11/154), while the bacteremia-attributable mortality was 3.9% (6/154). In multivariate analysis, septic shock was significantly associated with 30-day mortality (p = 0.0001). Attentive analysis of epidemiology and continuous microbiological surveillance are essential for the appropriate treatment of bacterial infections in pediatric onco-hematological patients.
format Online
Article
Text
id pubmed-8836920
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-88369202022-02-12 Characteristics and Outcomes of Bloodstream Infections in a Tertiary-Care Pediatric Hematology–Oncology Unit: A 10-Year Study Mattei, Davide Baretta, Valentina Mazzariol, Annarita Maccacaro, Laura Balter, Rita Zaccaron, Ada Bonetti, Elisa Chinello, Matteo Vitale, Virginia Caddeo, Giulia Esposto, Maria Pia Pezzella, Vincenza Gibellini, Davide Tridello, Gloria Cesaro, Simone J Clin Med Article Bloodstream infections (BSIs) after chemotherapy or hematopoietic stem cell transplantation (HSCT) are a leading cause of morbidity and mortality. Data on 154 BSIs that occurred in 111 onco-hematological patients (57 hematological malignancies, 28 solid tumors, and 26 non-malignant hematological diseases) were retrospectively collected and analyzed. Monomicrobial Gram-positive (GP), Gram-negative (GN), and fungal BSIs accounted for 50% (77/154), 38.3% (59/144), and 3.2% (5/154) of all episodes. Polymicrobial infections were 7.8% (12/154), while mixed bacterial–fungal infections were 0.6% (1/154). The most frequent GN isolates were Escherichia coli (46.9%), followed by Pseudomonas aeruginosa (21.9%), Klebsiella species (18.8%), and Enterobacter species (6.3%). Overall, 18.8% (12/64) of GN organisms were multidrug-resistant (seven Escherichia coli, three Klebsiella pneumoniae, and two Enterobacter cloacae), whereas GP resistance to glycopeptides was observed in 1% (1/97). Initial empirical antibiotic therapy was deemed inappropriate in 12.3% of BSIs (19/154). The 30-day mortality was 7.1% (11/154), while the bacteremia-attributable mortality was 3.9% (6/154). In multivariate analysis, septic shock was significantly associated with 30-day mortality (p = 0.0001). Attentive analysis of epidemiology and continuous microbiological surveillance are essential for the appropriate treatment of bacterial infections in pediatric onco-hematological patients. MDPI 2022-02-08 /pmc/articles/PMC8836920/ /pubmed/35160334 http://dx.doi.org/10.3390/jcm11030880 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Mattei, Davide
Baretta, Valentina
Mazzariol, Annarita
Maccacaro, Laura
Balter, Rita
Zaccaron, Ada
Bonetti, Elisa
Chinello, Matteo
Vitale, Virginia
Caddeo, Giulia
Esposto, Maria Pia
Pezzella, Vincenza
Gibellini, Davide
Tridello, Gloria
Cesaro, Simone
Characteristics and Outcomes of Bloodstream Infections in a Tertiary-Care Pediatric Hematology–Oncology Unit: A 10-Year Study
title Characteristics and Outcomes of Bloodstream Infections in a Tertiary-Care Pediatric Hematology–Oncology Unit: A 10-Year Study
title_full Characteristics and Outcomes of Bloodstream Infections in a Tertiary-Care Pediatric Hematology–Oncology Unit: A 10-Year Study
title_fullStr Characteristics and Outcomes of Bloodstream Infections in a Tertiary-Care Pediatric Hematology–Oncology Unit: A 10-Year Study
title_full_unstemmed Characteristics and Outcomes of Bloodstream Infections in a Tertiary-Care Pediatric Hematology–Oncology Unit: A 10-Year Study
title_short Characteristics and Outcomes of Bloodstream Infections in a Tertiary-Care Pediatric Hematology–Oncology Unit: A 10-Year Study
title_sort characteristics and outcomes of bloodstream infections in a tertiary-care pediatric hematology–oncology unit: a 10-year study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8836920/
https://www.ncbi.nlm.nih.gov/pubmed/35160334
http://dx.doi.org/10.3390/jcm11030880
work_keys_str_mv AT matteidavide characteristicsandoutcomesofbloodstreaminfectionsinatertiarycarepediatrichematologyoncologyunita10yearstudy
AT barettavalentina characteristicsandoutcomesofbloodstreaminfectionsinatertiarycarepediatrichematologyoncologyunita10yearstudy
AT mazzariolannarita characteristicsandoutcomesofbloodstreaminfectionsinatertiarycarepediatrichematologyoncologyunita10yearstudy
AT maccacarolaura characteristicsandoutcomesofbloodstreaminfectionsinatertiarycarepediatrichematologyoncologyunita10yearstudy
AT balterrita characteristicsandoutcomesofbloodstreaminfectionsinatertiarycarepediatrichematologyoncologyunita10yearstudy
AT zaccaronada characteristicsandoutcomesofbloodstreaminfectionsinatertiarycarepediatrichematologyoncologyunita10yearstudy
AT bonettielisa characteristicsandoutcomesofbloodstreaminfectionsinatertiarycarepediatrichematologyoncologyunita10yearstudy
AT chinellomatteo characteristicsandoutcomesofbloodstreaminfectionsinatertiarycarepediatrichematologyoncologyunita10yearstudy
AT vitalevirginia characteristicsandoutcomesofbloodstreaminfectionsinatertiarycarepediatrichematologyoncologyunita10yearstudy
AT caddeogiulia characteristicsandoutcomesofbloodstreaminfectionsinatertiarycarepediatrichematologyoncologyunita10yearstudy
AT espostomariapia characteristicsandoutcomesofbloodstreaminfectionsinatertiarycarepediatrichematologyoncologyunita10yearstudy
AT pezzellavincenza characteristicsandoutcomesofbloodstreaminfectionsinatertiarycarepediatrichematologyoncologyunita10yearstudy
AT gibellinidavide characteristicsandoutcomesofbloodstreaminfectionsinatertiarycarepediatrichematologyoncologyunita10yearstudy
AT tridellogloria characteristicsandoutcomesofbloodstreaminfectionsinatertiarycarepediatrichematologyoncologyunita10yearstudy
AT cesarosimone characteristicsandoutcomesofbloodstreaminfectionsinatertiarycarepediatrichematologyoncologyunita10yearstudy