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Abstract：
UNASSIGNED: The aim of this study was to investigate the current epidemiology, its changes during the study years, and inflammatory biomarkers of bacterial bloodstream infections (BSIs) in neutropenic patients with hematological malignancies. We assessed mortality risk factors and multidrug-resistant (MDR) gram-negative BSI predictors.
UNASSIGNED: We conducted a retrospective study from January 2015 to December 2021, which included adult neutropenic oncohematological patients with confirmed BSIs. We used univariable and multivariable analyses to analyze the risk factors. Each index\'s reliability for bacterial BSI diagnosis was assessed using the receiver-operating characteristic curve and area under the curve.
UNASSIGNED: A total of 514 isolates were obtained from the 452 patients. The average mortality was 17.71%. Gram-negative organisms were the predominant causes of BSI. Escherichia coli was the most common microorganism (49.90%). The overall variation trend of the isolation rate of MDR and carbapenem-resistant gram-negative bacteria increased. Multivariate analysis indicated that: 1) neutropenia that lasted for more than 7 days, patients ≥ 60 years of age, septic shock, hospitalization for >20 days, BSI with a carbapenem-resistant strain, and treatment with linezolid or vancomycin in infections lasting less than 30 days were independent mortality risk factors; 2) severe neutropenia exceeding 7 days, unreasonable empirical therapy, and receipt of aminoglycosides or 3rd or 4th generation cephalosporins in infections lasting less than 30 days were independent risk factors of MDR gram-negative bacteria. Procalcitonin, absolute neutrophil count, and white blood cell indicate higher diagnostic accuracy for BSIs. Moreover, bacteria time to detection was better at differentiating Gram-negative and Gram-positive bacterial infections.
UNASSIGNED: We analyzed the risk factors for BSI neutropenic patients with hematological malignancies, the distribution of bacteria, antibiotic resistance, and the changes in clinical parameters. This single-center retrospective study may provide clinicians with novel insights into the diagnosis and treatment of BSI to improve future clinical outcomes.
UNASSIGNED: We conducted a retrospective study from January 2015 to December 2021, which included adult neutropenic oncohematological patients with confirmed BSIs. We used univariable and multivariable analyses to analyze the risk factors. Each index\'s reliability for bacterial BSI diagnosis was assessed using the receiver-operating characteristic curve and area under the curve.
UNASSIGNED: A total of 514 isolates were obtained from the 452 patients. The average mortality was 17.71%. Gram-negative organisms were the predominant causes of BSI. Escherichia coli was the most common microorganism (49.90%). The overall variation trend of the isolation rate of MDR and carbapenem-resistant gram-negative bacteria increased. Multivariate analysis indicated that: 1) neutropenia that lasted for more than 7 days, patients ≥ 60 years of age, septic shock, hospitalization for >20 days, BSI with a carbapenem-resistant strain, and treatment with linezolid or vancomycin in infections lasting less than 30 days were independent mortality risk factors; 2) severe neutropenia exceeding 7 days, unreasonable empirical therapy, and receipt of aminoglycosides or 3rd or 4th generation cephalosporins in infections lasting less than 30 days were independent risk factors of MDR gram-negative bacteria. Procalcitonin, absolute neutrophil count, and white blood cell indicate higher diagnostic accuracy for BSIs. Moreover, bacteria time to detection was better at differentiating Gram-negative and Gram-positive bacterial infections.
UNASSIGNED: We analyzed the risk factors for BSI neutropenic patients with hematological malignancies, the distribution of bacteria, antibiotic resistance, and the changes in clinical parameters. This single-center retrospective study may provide clinicians with novel insights into the diagnosis and treatment of BSI to improve future clinical outcomes.
摘要：
■这项研究的目的是调查当前的流行病学，它在研究期间的变化，血液系统恶性肿瘤中性粒细胞减少患者的细菌血流感染（BSIs）的炎症生物标志物。我们评估了死亡危险因素和多药耐药（MDR）革兰氏阴性BSI预测因子。
■我们从2015年1月至2021年12月进行了一项回顾性研究，包括成人中性粒细胞减少症患者和确诊的BSI。我们使用单变量和多变量分析来分析危险因素。使用受试者工作特征曲线和曲线下面积评估每个指标对细菌BSI诊断的可靠性。
■总共从452名患者中获得514个分离株。平均死亡率为17.71%。革兰氏阴性菌是BSI的主要原因。大肠杆菌是最常见的微生物(49.90%)。耐多药耐药和耐碳青霉烯类革兰阴性菌分离率总体变化趋势升高。多因素分析表明:1)中性粒细胞减少持续7天以上,年龄≥60岁的患者，感染性休克,住院时间>20天，具有耐碳青霉烯菌株的BSI，利奈唑胺或万古霉素治疗持续时间少于30天是独立的死亡危险因素;2)严重中性粒细胞减少超过7天,不合理的经验疗法，持续少于30天的感染中接受氨基糖苷类或第3代或第4代头孢菌素是MDR革兰氏阴性菌的独立危险因素。降钙素原,中性粒细胞绝对计数,和白细胞表明BSI的诊断准确性更高。此外，细菌检测时间在区分革兰氏阴性和革兰氏阳性细菌感染方面更好。
■我们分析了BSI中性粒细胞减少患者合并血液系统恶性肿瘤的危险因素，细菌的分布，抗生素耐药性,以及临床参数的变化。这项单中心回顾性研究可能为临床医生提供BSI诊断和治疗的新见解，以改善未来的临床结果。
■我们从2015年1月至2021年12月进行了一项回顾性研究，包括成人中性粒细胞减少症患者和确诊的BSI。我们使用单变量和多变量分析来分析危险因素。使用受试者工作特征曲线和曲线下面积评估每个指标对细菌BSI诊断的可靠性。
■总共从452名患者中获得514个分离株。平均死亡率为17.71%。革兰氏阴性菌是BSI的主要原因。大肠杆菌是最常见的微生物(49.90%)。耐多药耐药和耐碳青霉烯类革兰阴性菌分离率总体变化趋势升高。多因素分析表明:1)中性粒细胞减少持续7天以上,年龄≥60岁的患者，感染性休克,住院时间>20天，具有耐碳青霉烯菌株的BSI，利奈唑胺或万古霉素治疗持续时间少于30天是独立的死亡危险因素;2)严重中性粒细胞减少超过7天,不合理的经验疗法，持续少于30天的感染中接受氨基糖苷类或第3代或第4代头孢菌素是MDR革兰氏阴性菌的独立危险因素。降钙素原,中性粒细胞绝对计数,和白细胞表明BSI的诊断准确性更高。此外，细菌检测时间在区分革兰氏阴性和革兰氏阳性细菌感染方面更好。
■我们分析了BSI中性粒细胞减少患者合并血液系统恶性肿瘤的危险因素，细菌的分布，抗生素耐药性,以及临床参数的变化。这项单中心回顾性研究可能为临床医生提供BSI诊断和治疗的新见解，以改善未来的临床结果。
