Clinical Characteristics of Bloodstream Infection in Immunosuppressed Patients: A 5-Year Retrospective Cohort Study

Abstract

IntroductionImmunosuppressed patients with bloodstream infection are at risk of mortality. Our objective was to assess the independent risk factors of bloodstream infection with mortality in immunosuppressive states.MethodsThe medical data of a total of 896 patients who were hospitalized in our hospital were collected from January 2015 to December 2019. Evaluation of the independent risk factors of mortality was done by univariate and multivariate logistic regression analyses.ResultsOf the 896 immunosuppressed patients with bloodstream infection, 698 had over 60-day survivals and 198 had 60-day mortality. In our study, PCT (mean ±; standard: 11.40 ±; 31.89 µg/l vs. 62.45 ±; 17.10 µg/l, p = 0.007) and presence of age >60 years (40% vs. 14.19%, p = 0.001) were significantly different between situations with and without 60-day survivals in both univariate and multivariate logistic regression analyses. Age >60 years and PCT could be used as indicators for bloodstream infection with 60-day death in immunosuppressive states; the OR (95% CI) were 1.532 (1.099–2.135) and 2.063 (1.413–3.013), respectively. In different subgroups, PCT and age were also independent risk factors of blood system diseases, Klebsiella pneumoniae infection, diabetes, and ICU-stay subgroups.ConclusionsAge and PCT were independently associated with mortality in immunosuppressive states, which may help to identify the highly risky situation of bloodstream infection in immunosuppressive states.

Prognostic Risk Factors of Carbapenem-Resistant Gram-Negative Bacteria Bloodstream Infection in Immunosuppressed Patients: A 7-Year Retrospective Cohort Study

“…This study showed that PCT was closely related to poor prognosis in immunosuppressed patients with CRGNB-BSI. Previous studies showed that increased PCT often suggests poor outcomes in both immunosuppressed patients with BSI and patients with CRGNB-BSI, 9 , 24 similar to the conclusion of our study. PCT is a predictor of poor prognosis in immunosuppressed patients with CRGNB infection.…”

“…Immunosuppressed patients are often admitted to the ICU due to multiple infections, and infectious complications lead to high mortality in immunosuppressed patients. 7 In previous studies, PCT and age were considered as independent risk factors for ICU admission, 9 consistent with the results of our study. Furthermore, it was found that use of tigecycline and development of AKI and septic shock could be prognostic predictors of ICU admission for immunosuppressed patients with CRGNB-BSI ( Table 4 ).…”

“…Cancer refers to both solid organ and hematological system tumors. Patients with a postoperative critical condition were identified when their blood culture was positive within 1 week following thoracotomy and laparotomy 9 , 10 ( Figure 1 ). Regarding the therapeutic strategy, monotherapy was defined as the use of one intravenous antibiotic, and combination therapy was defined as the concomitant use of at least two intravenous antibiotics.…”

“…7,8 They include patients receiving immunosuppressive therapy, such as oral immunosuppressive medications, chemotherapy, or radiotherapy; patients under transplantation states; patients with diseases such as diabetes, cancer, liver cirrhosis, and burns; and patients having a postoperative critical condition. 9,10 Previous studies explored certain specific immunosuppressed groups such as patients with cancers, transplantation status, hematological diseases, and diabetes, 5,[11][12][13] but there is still a lack of research on CRGNB-BSI in the overall immunosuppressed population.…”

The Prognostic Factors of Bloodstream Infection in Immunosuppressed Elderly Patients: A Retrospective, Single-center, Five-year Cohort Study

“…Immune suppression generally refers to low immune response to inflammation, and it is widely thought that a counter-inflammatory response aiming to inhabit overzealous inflammation may result in immune suppression. 1 This term is commonly used to qualify the immune status of patients with sepsis or systemic inflammatory response syndrome recently, which suggests that immune suppression indicates a status of immune failure making patients more vulnerable to the effects of diseases. 2 In general, typical immunosuppressed patients are usually transplant recipients and those with hematological malignancy, while atypical immunosuppression status may be present in patients with diabetes mellitus, liver cirrhosis, burns, and other diseases.…”