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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...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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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 |
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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 |
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