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Bloodstream infections in adult patients with cancer: clinical features and pathogenic significance of Staphylococcus aureus bacteremia

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Author(s)
Cheol-In KangJae-Hoon SongDoo Ryeon ChungKyong Ran PeckJoon-Sup YeomJun Seong SonYu Mi Withe Korean Network for Study on Infectious Diseases (KONSID)
Keimyung Author(s)
Ryu, Seong Yeol
Department
Dept. of Internal Medicine (내과학)
Journal Title
Supportive Care in Cancer
Issued Date
2012
Volume
20
Issue
10
Keyword
BacteremiaCancerStaphylococcus aureusTreatment outcome
Abstract
Objectives The aim of this study was to more precisely
delineate the characteristics and outcomes of bloodstream
infections in adult cancer patients.
Methods Using a database for nationwide surveillance of
bacteremia, we analyzed data related to bacteremia in
adult patients with cancer in order to evaluate clinical
features and outcomes and to define predictive factors
for mortality.
Results Of 1,246 patients, 896 (71.9%) had solid tumors, 328
(26.3%) had hematologic malignancies, and 22 (1.8%) had
both. The following conditions were more common in the
neutropenic group than in the non-neutropenic group: nosocomial
acquisition, hematologic malignancy, corticosteroid
use, immunosuppressant use, primary bacteremia, and pneumonia
(all P<0.05). The infections were caused by Gramnegative
bacilli in 55.6% and by Gram-positive cocci in
32.7%. Gram-negative pathogens were more frequently isolated
from neutropenic patients than from non-neutropenic
patients (61.9% vs. 53.5%, P00.010), with a significant
predominance of Escherichia coli and Klebsiella pneumoniae.
Among 1,001 patients whose outcomes could be
evaluated, the overall 30-day mortality rate was 24.1%,
and multivariate analysis showed that Staphylococcus aureus
bacteremia was a significant factor associated with mortality
(odds ratio (OR), 1.80; 95% confidence interval (CI),
1.03–3.15), along with nosocomial acquisition, pneumonia,
severe sepsis or septic shock, and higher Pitt bacteremia
score (all P values <0.05).
Conclusion This study represents the comprehensive assessment
of bloodstream infections in neutropenic versus
non-neutropenic cancer patients. Given the pathogenic
significance of S. aureus bacteremia in adult patients
with cancer, additional strategies for the management of
S. aureus bacteremia in cancer patients are needed to
improve outcomes.
Keywords Bacteremia . Cancer . Staphylococcus aureus .
Treatment outcome
Keimyung Author(s)(Kor)
류성열
Publisher
School of Medicine
Citation
Cheol-In Kang et al. (2012). Bloodstream infections in adult patients with cancer: clinical features and pathogenic significance of Staphylococcus aureus bacteremia. Supportive Care in Cancer, 20(10), 2371–2378. doi: 10.1007/s00520-011-1353-z
Type
Article
ISSN
0941-4355
Source
https://link.springer.com/article/10.1007%2Fs00520-011-1353-z
DOI
10.1007/s00520-011-1353-z
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/34428
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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