Contributions
Abstract: PB1593
Type: Publication Only
Session title: Infections in hematology (incl. supportive care/therapy)
Background
Infections caused by carbapenem-resistant Gram-negative bacteria (CRGNB) have a negative impact on the outcome of hospitalized patients, especially in regions with a high prevalence of CRGNB .Implementation of infection control measures significantly reduces their spread among critically ill patients in endemic areas . Early identification of rectal carriers of hematologic malignancies CRGNB at risk for clinical infection will facilitate better management and optimal use of healthcare resources.A retrospective study was conducted in a tertiary care hospital in China to identify the main factors associated with clinical infection in rectal carriers of hematological malignancies CRGNB and to develop a model to predict patients with such infection early.
Aims
To investigate the factors contributing to clinical infection in rectal carriers of carbapenem-resistant gram-negative bacteria (CRGNB) in hospitalized patients with hematological malignancies (HM) to develop an effective model for early identification of cases progressing to severe clinical CRGNB infection.
Methods
This retrospective single-center case-control study included CRGNB rectal carriers hospitalized for hematological malignancies from January 2018 to June 2020. The distribution of strains and clinical infection rate were analyzed. Multivariate analysis was performed by logistic regression model to identify risk factors.
Results
In this retrospective case-control study, the top three species detected in the Department of Hematology of our hospital on 2018-2020 (the first two quarters) were: Klebsiella pneumoniae 137 (33.1%), Escherichia coli 72 (17.4%), and Baumannii 69 (16.7%); univariate analysis showed that patients induced remission chemotherapy, transplantation, mucositis, duration of particle deficiency, nutritional status (albumin), infectious drug exposure (such as carbapenems, aminoglycosides, chemotherapy, immunosuppressive agents, glucocorticoids, antacids (PPIs), etc.); invasive procedures before infection (such as arterial/venous, sputum suction, catheterization, etc.), and the differences were statistically significant (p < 0.05). Multivariate logistic regression analysis indicated that remission induction chemotherapy, duration of particle deficiency, mucositis, and nutritional status (hypoalbuminemia) were independent risk factors for clinical infection in CRGNB rectal carriers. Among them, skin mucositis and particle gap time ≥ 15 days were the most important independent risk factors for clinical infection in CRGNB rectal carriers; the model for predicting CRGNB infection was effective, and the predictive efficacy of the risk prediction score table was validated by ROC curve, with an area under the characteristic curve of 0.697 (95% CI 0.647-0.747, p＜0.05).
Conclusion
It can help early and accurately predict rectal carriers of hematologic malignancies CRGNB at risk for clinical infection. Patients in the high-risk group (>3.5) should take more effective prophylactic antibiotics and undergo more rigorous monitoring. The model showed excellent predictive performance and showed good discrimination.
Keyword(s):
Abstract: PB1593
Type: Publication Only
Session title: Infections in hematology (incl. supportive care/therapy)
Background
Infections caused by carbapenem-resistant Gram-negative bacteria (CRGNB) have a negative impact on the outcome of hospitalized patients, especially in regions with a high prevalence of CRGNB .Implementation of infection control measures significantly reduces their spread among critically ill patients in endemic areas . Early identification of rectal carriers of hematologic malignancies CRGNB at risk for clinical infection will facilitate better management and optimal use of healthcare resources.A retrospective study was conducted in a tertiary care hospital in China to identify the main factors associated with clinical infection in rectal carriers of hematological malignancies CRGNB and to develop a model to predict patients with such infection early.
Aims
To investigate the factors contributing to clinical infection in rectal carriers of carbapenem-resistant gram-negative bacteria (CRGNB) in hospitalized patients with hematological malignancies (HM) to develop an effective model for early identification of cases progressing to severe clinical CRGNB infection.
Methods
This retrospective single-center case-control study included CRGNB rectal carriers hospitalized for hematological malignancies from January 2018 to June 2020. The distribution of strains and clinical infection rate were analyzed. Multivariate analysis was performed by logistic regression model to identify risk factors.
Results
In this retrospective case-control study, the top three species detected in the Department of Hematology of our hospital on 2018-2020 (the first two quarters) were: Klebsiella pneumoniae 137 (33.1%), Escherichia coli 72 (17.4%), and Baumannii 69 (16.7%); univariate analysis showed that patients induced remission chemotherapy, transplantation, mucositis, duration of particle deficiency, nutritional status (albumin), infectious drug exposure (such as carbapenems, aminoglycosides, chemotherapy, immunosuppressive agents, glucocorticoids, antacids (PPIs), etc.); invasive procedures before infection (such as arterial/venous, sputum suction, catheterization, etc.), and the differences were statistically significant (p < 0.05). Multivariate logistic regression analysis indicated that remission induction chemotherapy, duration of particle deficiency, mucositis, and nutritional status (hypoalbuminemia) were independent risk factors for clinical infection in CRGNB rectal carriers. Among them, skin mucositis and particle gap time ≥ 15 days were the most important independent risk factors for clinical infection in CRGNB rectal carriers; the model for predicting CRGNB infection was effective, and the predictive efficacy of the risk prediction score table was validated by ROC curve, with an area under the characteristic curve of 0.697 (95% CI 0.647-0.747, p＜0.05).
Conclusion
It can help early and accurately predict rectal carriers of hematologic malignancies CRGNB at risk for clinical infection. Patients in the high-risk group (>3.5) should take more effective prophylactic antibiotics and undergo more rigorous monitoring. The model showed excellent predictive performance and showed good discrimination.
Keyword(s):