Impact of chemotherapy resumption on the outcome of Staphylococcus aureus bacteremia in patients with solid tumors

Abstract

Purpose Staphylococcus aureus bacteremia (SAB) is a common infection in patients with solid tumors undergoing chemotherapy. In medical oncology, this dilemma often arises between infection control and cancer treatment. We aimed to explore whether early resumption of chemotherapy yielded unfavorable outcomes in oncologic patients with SAB. Methods We retrospectively reviewed patients who received antineoplastic chemotherapy within 90 days of SAB onset. We divided patients who resumed chemotherapy into early and late resumption groups and investigated whether chemotherapy after SAB was associated with treatment failure. Treatment failure included recurrence or relapse, 90-day all-cause mortality after initiation of antibiotics toward susceptible microorganisms, and 30-day all-cause mortality after resumption of chemotherapy. Results Among the 78 eligible patients, catheter-related bloodstream infection was the most common (51 patients, 65.4%). Thirty-six patients (46.2%) resumed chemotherapy under the supervision of infectious disease specialists. The median interval from the date of negative blood culture to the date of chemotherapy resumption was 17.5 days (0–69). Two patients in the early resumption group (\(<\)17.5 days, 11.1%) and one in the late resumption group (\(\ge\) 17.5 days, 5.6%) died within 90 days after the initiation of antibiotics toward susceptible microorganisms. One patient (5.6%) in the early resumption group experienced SAB recurrence. None of the patients experienced SAB relapse or died within 30 days of resuming chemotherapy. Conclusion Early resumption of chemotherapy may not be directly associated with unfavorable outcomes in SAB in patients with solid tumors under appropriate infection management.

Impact of Early Chemotherapy Resumption on the Outcome after Staphylococcus aureus Bacteremia in Patients with Solid Tumors: A Retrospective Study in a Single Tertiary Cancer Center in Japan

“…Exclusion criteria were as follows: (1) no follow-up data after SAB (e.g., transfer to another hospital), (2) polymicrobial bacteremia, (3) no documentation of negative blood culture after SAB, (4) hormonal therapy as antineoplastic chemotherapy, or (5) hematologic malignancy. A preprint has previously been published [15].…”