A PRACTICAL UPDATE ON THE EPIDEMIOLOGY AND RISK FACTORS FOR THE EMERGENCE AND MORTALITY OF BLOODSTREAM INFECTIONS IN 3014 PATIENTS WITH HEMATOLOGICAL MALIGNANCY RECEIVING CHEMOTHERAPY
Author(s): ,
Jianda Hu
Affiliations:
Hematology,Fujian Medical University Union Hospital,Fuzhou,China
,
Shaozhen Chen
Affiliations:
Hematology,Fujian Medical University Union Hospital,Fuzhou,China
Ting Yang
Affiliations:
Hematology,Fujian Medical University Union Hospital,Fuzhou,China
EHA Library. Chen z. Jun 15, 2019; 266896; PS1279
zhen Chen
zhen Chen
Contributions
Abstract

Abstract: PS1279

Type: Poster Presentation

Presentation during EHA24: On Saturday, June 15, 2019 from 17:30 - 19:00

Location: Poster area

Background
The pathogenic epidemiology, antibiotic resistance, and risk factors of bloodstream infections (BSIs) in patients with hematologic malignancies (HMs) receiving chemotherapy is importment for clinican.

Aims
To investigate the pathogenic epidemiology and antibiotic resistance of bloodstream infections (BSIs) in patients with hematologic malignancies (HMs) receiving chemotherapy, and to determine the risk factors for BSIs. 

Methods
Retrospective chart review of patients diagnosed with HMs (n=3014) was performed (1/2013-12/2016), and patients classified as having BSIs (n=725) or not (n=2289). Clinical characteristics and pathogens were evaluated, and risk factors for BSIs identified by univariate and multivariate Logtistic and COX regression analyses.

Results
BSI frequency was 24.1%, with 744 different isolated strains in 725 cases.Gram-negative (G-) represented 64.7% of the 744 isolated strains, while Gram-positive (G+) and fungi were 27.7% and 7.7%, respectively. The most common isolates were Klebsiella pneumoniae (19.2%), and 90% of extended-spectrum beta-lactamases (ESBL)-producing enterobacteria were multidrug-resistant. Methicillin-resistant Coagulase-negative Staphylococci and Methicillin-resistant Staphylococcus aureus accounted for 87.16% and 37.93% of the cases, respectively. Multivariate analysis revealed that male, age ≥ 45 and < 65 yr, hospital length of stay (LOS) ≥ 9d, neutropenia ≥ 7d before BSIs, ≥ 2 antibiotics, gastrointestinal, perirectal and urinary tract infections independently predicted BSIs emergence. Furthermore, age ≥ 65, neutropenia ≥ 7d before BSIs, no HM remission, lower white blood cell count, ≥ 3 antibiotics, respiratory infections, and Acinetobacter baumannii and Stenotrophomonas maltophilia BSIs were independent predictors of 30-day mortality. 

Conclusion
Antibiotic resistance was highoutcome was poor, and mortality due to BSIs was high in this patient cohort. Therefore, close attention should be paid to the risk factors identified here during management of these patients with BSIs.

Session topic: 30. Infectious diseases

Keyword(s): Hematological malignancy, Infection, Resistance, Risk factor

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