Polymicrobial bacteremia in cancer patients: analysis of risk factors, etiology and outcome in 214 episodes

Ilavská, I.; Pichňa, P.; Stopkova, K.; Grausova, S.; Krupova, I.; Oravcova, E.; Koreň, P.; Lacka, J.; Studena, M.; Špánik, S.; Kunová, A.; Trupl, J.; Krčméry, V.

doi:10.1016/0924-8579(96)00307-x

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…This finding is consistent with those of previous studies and suggests that polymicrobial infection was not an independent risk factor for mortality of A. baumannii bacteremia [10,11,22,23]. Although several studies have reported higher mortality rates in patients with polymicrobial bacteremia [3,5,6,24], the attributable mortality rate of polymicrobial bacteremia varied among causative pathogens [3,25,26]. Compared with monomicrobial bacteremia, polymicrobial bacteremia involving Staphylococcus aureus [27], Enterococcus spp.…”

Section: Discussionsupporting

confidence: 91%

Is Polymicrobial Bacteremia an Independent Risk Factor for Mortality in Acinetobacter baumannii Bacteremia?

Wang

Yang

et al. 2020

JCM

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This retrospective observational study assessed the differences between monomicrobial and polymicrobial A. baumannii bacteremia and identified possible independent risk factors for 14-day mortality. There were 379 patients with A. baumannii bacteremia admitted to a tertiary care center in northern Taiwan between August 2008 and July 2015 enrolled for data analysis. Among them, 89 patients (23.5%) had polymicrobial bacteremia and 290 patients (76.5%) had monomicrobial bacteremia. No significant difference in 14-day mortality was observed between patients with monomicrobial and polymicrobial A. baumannii bacteremia (26.9% vs. 29.2%, p = 0.77). Logistic regression controlled for confounders demonstrated that polymicrobial bacteremia was not an independent predictor of mortality, whereas appropriate antimicrobial therapy was independently associated with reduced mortality. Higher 14-day mortality rates were observed in the polymicrobial bacteremic patients with concomitant isolation of Escherichia coli, Pseudomonas aeruginosa, and Enterobacter spp. from the bloodstream. Compared with patients with monomicrobial multidrug-resistant A. baumannii (MDRAb) bacteremia, those with MDRAb concomitant with Gram-negative bacilli bacteremia had a worse outcome. Polymicrobial A. baumannii bacteremia was not associated with a higher 14-day mortality rate than that of monomicrobial A. baumannii bacteremia, although more deaths were observed when certain Gram-negative bacteria were concomitantly isolated. Appropriate antimicrobial therapy remains an important life-saving measure for A. baumannii bacteremic patients.

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Section: Discussionsupporting

confidence: 91%

Is Polymicrobial Bacteremia an Independent Risk Factor for Mortality in Acinetobacter baumannii Bacteremia?

Wang

Yang

et al. 2020

JCM

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“…In this study, monomicrobial infections were not associated with lower mortality rates from all MDR Gram-negative bacteria, which is also an important finding and compatible with other authors. Although multiple studies have reported higher mortality rates in bacteremic patients with polymicrobial infection [ 66 , 67 ], the attributable mortality rate varied depending on the causative pathogen isolated [ 68 , 69 ]. Compared with monomicrobial bacteremia, polymicrobial bacteremia of P. aeruginosa [ 70 ] was associated with higher mortality, while polymicrobial K. pneumoniae bacteremia did not led to poorer outcomes [ 71 ].…”

Section: Discussionmentioning

confidence: 99%

Mortality Due to Multidrug-Resistant Gram-Negative Bacteremia in an Endemic Region: No Better Than a Toss of a Coin

et al. 2023

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The incidence of multidrug-resistant (MDR) bloodstream infections (BSIs) is associated with high morbidity and mortality. Little evidence exists regarding the epidemiology of BSIs and the use of appropriate empirical antimicrobial therapy in endemic regions. Novel diagnostic tests (RDTs) may facilitate and improve patient management. Data were assessed from patients with MDR Gram-negative bacteremia at a university tertiary hospital over a 12-month period. In total, 157 episodes of MDR Gram-negative BSI were included in the study. The overall mortality rate was 50.3%. Rapid molecular diagnostic tests were used in 94% of BSI episodes. In univariate analysis, age (OR 1.05 (95% CI 1.03, 1.08) p < 0.001), Charlson Comorbidity Index (OR 1.51 (95% CI 1.25, 1.83) p < 0.001), procalcitonin ≥ 1(OR 3.67 (CI 95% 1.73, 7.79) p < 0.001), and monotherapy with tigecycline (OR 3.64 (95% CI 1.13, 11.73) p = 0.030) were the only factors associated with increased overall mortality. Surprisingly, time to appropriate antimicrobial treatment had no impact on mortality. MDR pathogen isolation, other than Klebsiella pneumoniae and Acinetobacter baumanii, was associated with decreased mortality (OR 0.35 (95% CI 0.16, 0.79) p = 0.011). In multivariate analysis, the only significant factor for mortality was procalcitonin ≥ 1 (OR 2.84 (95% CI 1.13, 7.11) p = 0.025). In conclusion, in an endemic area, mortality rates in MDR BSI remain notable. High procalcitonin was the only variable that predicted death. The use of rapid diagnostics did not improve mortality rate.

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Identifying and Classifying Bloodstream Infections Among Hemodialysis Patients

Kallen

2013

Seminars in Dialysis

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Bloodstream infections (BSIs) are a prominent clinical problem in patients undergoing hemodialysis. These infections appear to be more common among patients who have a central line as their dialysis access and can be associated with substantial morbidity and mortality. Accurately diagnosing BSIs clearly influences patient management, but is also an important part of an infection prevention program; particularly as facility BSI rates are becoming a recognized quality measure for which dialysis facilities might be held accountable. Blood cultures remain the gold standard for diagnosing BSIs and a number of practices can affect the sensitivity and specificity of this important laboratory test. Optimizing the collection of blood cultures can assist providers with interpretation of positive blood cultures and can help minimize the impact of false-positive and false-negative cultures. This review will describe differences between BSI definitions, examine the use of blood cultures to identify these infections including the use of recommended best practices to maximize culture yield, and highlight characteristics that can assist in the clinical interpretation of positive blood cultures.

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Polymicrobial bacteremia in cancer patients: analysis of risk factors, etiology and outcome in 214 episodes

Cited by 3 publications

References 6 publications

Is Polymicrobial Bacteremia an Independent Risk Factor for Mortality in Acinetobacter baumannii Bacteremia?

Is Polymicrobial Bacteremia an Independent Risk Factor for Mortality in Acinetobacter baumannii Bacteremia?

Mortality Due to Multidrug-Resistant Gram-Negative Bacteremia in an Endemic Region: No Better Than a Toss of a Coin

Identifying and Classifying Bloodstream Infections Among Hemodialysis Patients

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