Contributions
Abstract: EP817
Type: E-Poster Presentation
Session title: Infections in hematology (incl. supportive care/therapy)
Background
Patients with hematological malignancies have higher risk of acquiring infectious complications and bacterial bloodstream infections.
Aims
The aim of the study evaluated epidemiology, outcome and risk factors of mortality in bacteraemia in adult patients with hematologic malignancies.
Methods
In this retrospective study, all adult patients with hematologic malignancies who developed documented bacteraemia between January 2010 and December 2019 were evaluated. Risk factors with a P-value less than 0.20 were initially included in the binary logistic regression model to determine the independent risk factors for mortality Bloodstream infection in adult hematologic malignancies. Then the model was reduced by means of manual backward elimination. P values of 0.05 or less were considered statistically significant.
Results
Two hundred and thirty one bacteraemia episodes were identified in 174 patients. Acute myeloid leukaemia (AML) was the most common and accounted for 57.1% followed by acute lymphocytic leukaemia (ALL) for 31.2%. The bacteraemia occurred in 140 patients (60.6%) with uncontrolled/relapse or refractory disease (89 (38.5%) of them during induction chemotherapy). Neutropenia was observed in 207 episodes (89.6%), during more than 10 days in 172 episodes (74.5%) and more than 80% have severe neutropenia. Gram-negative and Gram-positive bacteria accounted for 179 (77.5%) and 52 (22.5%) of bacteraemias pathogens, consequently. In blood cultures; Klebsiella pneumonia, Escherichia coli and Staphylococcus aureus were detected in 34.6%, 17.3% and 15.6% of the samples, respectively. Fifty-eight of the bacteraemias pathogens were multi-drug resistant bacteria (25.1%). Thirty-five (15.2%) of the cultured Gram-negative bacterias were extended spectrum beta-lactamase (ESBL). Carbapenemase positive culture was in 25 episodes (10.8%) in Gram-negative bacteria cultures. During 90 (39%) episodes of bacteraemias, patients had sepsis related organ failure or organ dysfunction. Forty-seven died related to a bacteraemias (K. pneumoniae bacteraemias had the highest case-mortality (25 cases)). The independent risk Factors influencing mortality were : MASCC<21 (P: 0.039) and qSOFA>2 (P: <10ˉ³).
Conclusion
Our study shows that Gram-negative bacteria are predominant for this population. In our population, MASCC<21 and qSOFA>2 increase the mortality rate.
Keyword(s): Hematological malignancy, Infection, Mortality
Abstract: EP817
Type: E-Poster Presentation
Session title: Infections in hematology (incl. supportive care/therapy)
Background
Patients with hematological malignancies have higher risk of acquiring infectious complications and bacterial bloodstream infections.
Aims
The aim of the study evaluated epidemiology, outcome and risk factors of mortality in bacteraemia in adult patients with hematologic malignancies.
Methods
In this retrospective study, all adult patients with hematologic malignancies who developed documented bacteraemia between January 2010 and December 2019 were evaluated. Risk factors with a P-value less than 0.20 were initially included in the binary logistic regression model to determine the independent risk factors for mortality Bloodstream infection in adult hematologic malignancies. Then the model was reduced by means of manual backward elimination. P values of 0.05 or less were considered statistically significant.
Results
Two hundred and thirty one bacteraemia episodes were identified in 174 patients. Acute myeloid leukaemia (AML) was the most common and accounted for 57.1% followed by acute lymphocytic leukaemia (ALL) for 31.2%. The bacteraemia occurred in 140 patients (60.6%) with uncontrolled/relapse or refractory disease (89 (38.5%) of them during induction chemotherapy). Neutropenia was observed in 207 episodes (89.6%), during more than 10 days in 172 episodes (74.5%) and more than 80% have severe neutropenia. Gram-negative and Gram-positive bacteria accounted for 179 (77.5%) and 52 (22.5%) of bacteraemias pathogens, consequently. In blood cultures; Klebsiella pneumonia, Escherichia coli and Staphylococcus aureus were detected in 34.6%, 17.3% and 15.6% of the samples, respectively. Fifty-eight of the bacteraemias pathogens were multi-drug resistant bacteria (25.1%). Thirty-five (15.2%) of the cultured Gram-negative bacterias were extended spectrum beta-lactamase (ESBL). Carbapenemase positive culture was in 25 episodes (10.8%) in Gram-negative bacteria cultures. During 90 (39%) episodes of bacteraemias, patients had sepsis related organ failure or organ dysfunction. Forty-seven died related to a bacteraemias (K. pneumoniae bacteraemias had the highest case-mortality (25 cases)). The independent risk Factors influencing mortality were : MASCC<21 (P: 0.039) and qSOFA>2 (P: <10ˉ³).
Conclusion
Our study shows that Gram-negative bacteria are predominant for this population. In our population, MASCC<21 and qSOFA>2 increase the mortality rate.
Keyword(s): Hematological malignancy, Infection, Mortality