Bloodstream infections in cancer patients. Risk factors associated with mortality

Islas-Muñoz, Beda; Volkow-Fernández, Patricia; Ibanes-Gutiérrez, Cynthia; Villamar-Ramírez, Alberto; Vilar‐Compte, Diana; Cornejo-Juárez, Patricia

doi:10.1016/j.ijid.2018.03.022

Cited by 93 publications

(102 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, most of patients with malignancy bear the risk for infections by multidrug-resistant bacteria probably due to frequent hospitalizations leading to colonization by that species [13]. It is evident that this has a major impact on 28-day outcome through the intake of inappropriate antimicrobial therapy [13,14]. Two major limitations of the study need to be addressed; matching for appropriateness of antimicrobial therapy and quality of care between study sites.…”

Section: Discussionmentioning

confidence: 99%

Past history of stage I/II solid tumor malignancy impacts considerably on sepsis mortality: a propensity score matching analysis from the hellenic sepsis study group

Dimοpoulos

Rovina

Patrani³

et al. 2019

BMC Infect Dis

View full text Add to dashboard Cite

Background: Whether past history of solid stage I/II inactive cancer has an impact on 28-day mortality of sepsis remains unclear. We aimed to determine the impact of history of stage I or II solid tumor malignancy in complete remission the last 3 years on sepsis outcome. Methods: Using the database of the Hellenic Sepsis Study Group from 1553 patients with sepsis admitted in the ICU, 83 patients with sepsis by Sepsis-3 definition with past-history of stage I/II inactive solid malignancy the last 3 years were depicted. A comparator group of 83 patients fully matched for age, severity, type of infection and comorbidities was selected by propensity score matching. Results: Mortality after 28 days was 37.3% in the comparator group and 54.2% in the solid tumor stage I/II group (odds ratio for death 1.98; p: 0.030). Following step-wise forward Cox regression analysis, septic shock (hazard ratio 1.80), acute renal injury (hazard ratio 2.06), history of coronary heart disease (hazard ratio 0.36) and history of stage I/II solid tumor malignancy (hazard ratio 1.79) were the only independent variables associated with 28-day mortality. Serum levels of procalcitonin and of soluble urokinase plasminogen activator receptor were similar between the two groups of comparisons. Conclusions: Past history of stage I/II solid malignancy is an independent risk factor for unfavorable outcome from sepsis the first 28 days.

show abstract

Section: Discussionmentioning

confidence: 99%

Past history of stage I/II solid tumor malignancy impacts considerably on sepsis mortality: a propensity score matching analysis from the hellenic sepsis study group

Dimοpoulos

Rovina

Patrani³

et al. 2019

BMC Infect Dis

View full text Add to dashboard Cite

show abstract

“…After a full-text review of the remaining 148 articles, 121 articles were excluded. Finally, 27 studies were considered eligible, with 24 included in the meta-analysis for MRSA prevalence (5,13,, three in the potential MRSA predictors (50)(51)(52), and two in the risk factors for mortality in patients with MRSA BSIs (53). The selected studies scored ve or six according to the Newcastle-Ottawa scale and were considered of high or moderate quality (Supplementary Table S1).…”

Section: Resultsmentioning

confidence: 99%

Prevalence, Predictors, and Mortality of Bloodstream Infections Due to Methicillin-Resistant Staphylococcus Aureus in Patients with Malignancy: Systemic Review and Meta-Analysis

Zhuang

Wang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Cancer patients are more likely to develop and die of bloodstream infection (BSI) than noncancer patients. Methicillin-resistant Staphylococcus aureus (MRSA), which is associated with immense mortality and economic burden worldwide, is not covered by the recommended initial antibiotic therapy for cancer patients with BSI. This systemic review was performed to estimate the global methicillin-resistant Staphylococcus aureus (MRSA) prevalence among bacteremia in patients with malignancy, and further study the predictors and mortality of cancer patients with MRSA bacteremia. Methods: The PubMed and EMBASE databases were searched for studies published from Jan. 2000 to Mar. 2020 that provided primary data on the prevalence, predictors, or mortality of MRSA bacteremia in cancer patients. A random-effects model meta-analysis was performed to estimate the pooled prevalence of MRSA with 95% confidence intervals (95% CIs).Results: The pooled prevalence of MRSA was 3% (95% CI 2–5%) among all bloodstream infections (BSIs) and 44% (95% CI 32–57%) among S. aureus bacteremia in cancer patients. Based on geographical stratification, the pooled prevalence was 5% in Africa (95% CI 1–14%), 1% in Americas (95% CI 1–2%), 2% in Europe (95% CI 1–4%), 4% in Western Pacific (95% CI 2–7%), 8% in South-east Asia (95% CI 4–14%) and 0% in Eastern Mediterranean (95% CI 0–3%). No significant temporal change in MRSA rates was detected in this analysis (R2 = 0.06; P=0.24). Predictors for MRSA BSIs among cancer patients were identified by comparison with their methicillin-susceptible counterparts, and they were mainly related to healthcare-associated infections and immunosuppression. Finally, the 60-day mortality in adult cancer patients with MRSA BSIs was reported to be 12%, and the 6-month overall mortality was 43.2%, with community-onset infection, secondary BSI, and vancomycin MIC≥2g/mL being the risk factors for mortality.Conclusions: Although the prevalence of MRSA BSIs among cancer patients is relatively low, it did not decline over time as MRSA BSIs in the general hospital population and the high mortality rate was related to MRSA BSIs in patients with malignancy.

show abstract

“…After a full-text review of the remaining 148 articles, 121 articles were excluded. Finally, 27 studies were considered eligible, with 24 included in the meta-analysis for MRSA prevalence (5,13,, three in the potential MRSA predictors (50-52), and two in the risk factors for mortality in patients with MRSA BSIs (53). The selected studies scored ve or six according to the Newcastle-Ottawa scale and were considered of high or moderate quality (Supplementary Table S1).…”

Section: Resultsmentioning

confidence: 99%

“…Among a subset of 23 studies that contained data on 3690 Gram-positive BSI cases, the MRSA isolation rate in Gram-positive bacteria was 10% (95% CI 6-14%) (5,13,(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(47)(48)(49). In 15 studies whose number of S. aureus was more than 10, the pooled prevalence of MRSA among S. aureus was 44% (95% CI 32-57%) (5,13,28,32,34,36,38,(41)(42)(43)(44)(45)(46)(47)(48).…”

Section: Prevalence Of Mrsa-bsismentioning

confidence: 99%

See 1 more Smart Citation

Prevalence, predictors, and mortality of bloodstream infections due to methicillin-resistant Staphylococcus aureus in patients with malignancy: systemic review and meta-analysis

Zhuang

Wang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: This systemic review was performed to estimate the global methicillin-resistant Staphylococcus aureus (MRSA) prevalence among bacteremia in patients with malignancy, and further study the predictors and mortality of cancer patients with MRSA bacteremia. Methods: The PubMed and EMBASE databases were searched for studies published from Jan. 2000 to Mar. 2020. A random-effects model meta-analysis was performed to estimate the pooled prevalence of MRSA with 95% confidence intervals (95% CIs).Results: The pooled prevalence of MRSA was 3% (95% CI 2–5%) among all bloodstream infections (BSIs) and 44% (95% CI 32–57%) among S. aureus bacteremia in cancer patients. Based on geographical stratification, the pooled prevalence was 5% in Africa (95% CI 1–14%), 1% in Americas (95% CI 1–2%), 2% in Europe (95% CI 1–4%), 4% in Western Pacific (95% CI 2–7%), 8% in South-east Asia (95% CI 4–14%) and 0% in Eastern Mediterranean (95% CI 0–3%). No significant temporal change in MRSA rates was detected in this analysis (R2 = 0.06; P=0.24). Predictors for MRSA BSIs among cancer patients were identified by comparison with their methicillin-susceptible counterparts, and they were mainly related to healthcare-associated infections and immunosuppression. Finally, the 60-day mortality in adult cancer patients with MRSA BSIs was reported to be 12%, and the 6-month overall mortality was 43.2%, with community-onset infection, secondary BSI, and vancomycin MIC≥2g/mL being the risk factors for mortality.Conclusions: Although the prevalence of MRSA BSIs among cancer patients is relatively low, it did not decline over time as MRSA BSIs in the general hospital population and the high mortality rate was related to MRSA BSIs in patients with malignancy.

show abstract

Bloodstream infections in cancer patients. Risk factors associated with mortality

Abstract: Emergence of MDR bacteria is an important healthcare problem worldwide. Patients with BSI, particularly those patients with MDR bacteria have a higher mortality risk.

Cited by 93 publications

References 21 publications

Past history of stage I/II solid tumor malignancy impacts considerably on sepsis mortality: a propensity score matching analysis from the hellenic sepsis study group

Past history of stage I/II solid tumor malignancy impacts considerably on sepsis mortality: a propensity score matching analysis from the hellenic sepsis study group

Prevalence, Predictors, and Mortality of Bloodstream Infections Due to Methicillin-Resistant Staphylococcus Aureus in Patients with Malignancy: Systemic Review and Meta-Analysis

Prevalence, predictors, and mortality of bloodstream infections due to methicillin-resistant Staphylococcus aureus in patients with malignancy: systemic review and meta-analysis

Contact Info

Product

Resources

About