Abstract:
:Multiresistant bacterial infections are a potentially life-threatening condition in acute leukaemia (AL) patients. We aimed to better define the very recent epidemiology and outcome of bloodstream infections (BSIs) in a real-life setting. We prospectively collected all consecutive febrile/infectious episodes occurring in AL patients admitted to 9 haematology units. In 293 AL patients, 433 BSIs were diagnosed. Gram-positive (GP) bacteria were isolated in 44.8 % BSI and Gram-negative (GN) in 38.3 %, while polymicrobial aetiology- or fungi-related events were identified in 15.7 and 1.1 % of the cases, respectively. GP was observed more frequently in patients not in complete remission (p = 0.04), while GN during consolidation cycles (p = 0.003). Extended spectrum β-lactamase-producing strains accounted for 23.2 % of enterobacteria. They were associated with previous antibiotic exposure, including fluoroquinolones prophylaxis (p = 0.01). Carbapenem-resistant (CR) strains occurred in 9 % of enterobacteria. Among Pseudomonas aeruginosa strains, 21.6 % were multiresistant. Overall 30-day mortality was 8.5 %. CR GN and multiresistant P. aeruginosa BSIs were independent predictors of death (p = 0.002), as well as relapsed/resistant AL (18.3 %; p = 0.0002) and the presence of pulmonary infiltrates (26.6 %; p < 0.001). Although GP still predominate over GN BSI, the percentage of antibiotic resistant GN strains is considerable in AL patients and it is associated with poor prognosis.
journal_name
Ann Hematoljournal_title
Annals of hematologyauthors
Cattaneo C,Zappasodi P,Mancini V,Annaloro C,Pavesi F,Skert C,Ferrario A,Todisco E,Saccà V,Verga L,Passi A,Da Vià M,Ferrari S,Mometto G,Petullà M,Nosari A,Rossi Gdoi
10.1007/s00277-016-2815-7subject
Has Abstractpub_date
2016-12-01 00:00:00pages
1955-1963issue
12eissn
0939-5555issn
1432-0584pii
10.1007/s00277-016-2815-7journal_volume
95pub_type
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