Risk factors for bloodstream infections in gynecological cancer

Abstract

ObjectiveInfections are a threat to frail patients as they have a higher risk of developing serious complications from bloodstream pathogens. The aim of this study was to determine which factors can predict or diagnose bloodstream infections in patients with an underlying gynecologic malignancy.Materials and MethodsBetween July 2016 and December 2017, 68 patients visiting the emergency room with an underlying gynecologic malignancy were evaluated. Variables concerning underlying disease, invasive procedures, and laboratory and clinical parameters were analyzed. Patients were divided into three groups based on their blood and urine specimens (positive blood specimens, positive urine specimens, and no positive specimens; patients who had both positive blood and urine specimens were included in the group of positive blood specimens). Risk factors for surgical site infections, recent (<30 days) surgery, and chemotherapy were studied separately.Results68 patients were included in the analysis. Mean age was 55.6 years (standard deviation 14.1). 44% of patients had ovarian cancer, 35% cervical cancer, 12% endometrial cancer, and 9% had other cancer types. In total, 96% of all patients had undergone surgery. Patients who had been treated with chemotherapy were at a higher risk of developing bloodstream infection (P=0.04; odds ratio (OR)=7.9). C reactive protein, bilirubin, and oxygen saturation (SO2) were significantly different between patients with an underlying infection and those who had none. Only C reactive protein maintained its significance in a linear model, with a cut-off of 180 mg/L (linear regression, P=0.03; OR=4).ConclusionsChemotherapy is a risk factor for the development of bloodstream infections in patients with an underlying gynecologic malignancy; C reactive protein could be a useful tool in making this diagnosis.

The proportion, species distribution and dynamic trends of bloodstream infection cases in a tertiary hospital in China, 2010–2019

“…This result was consistent with the increase in various hospital-acquired infections in recent years [19,20]. In addition, the risk factors may be related to the risk factors for BSI and (or) hospital-acquired infections reported in many previous studies, such as ICU admission, the older age of hospitalized patients (aging population), prolonged hospital stay, leukocytopenia, acute myeloid leukemia and (or) increased use of invasive procedures including central venous catheters (CVC) [21][22][23]. However, more details of the risk factors require further statistical analysis of the decrease in hospital-acquired BSI in our hospital.…”

The incidence rate, species distribution and dynamic trends of bloodstream infection in China, 2010-2019

“…However, we also found that the composition ratio of hospital acquired BSIs increased significantly annually (from 73.4-76.2%). This result was consistent with the increase in various hospital-acquired infections in recent years [16,17] , and the risk factors may be related to the risk factors for BSIs and (or) hospital-acquired infections reported in many previous studies, such as ICU admission, the older age of hospitalized patients (aging population), prolonged hospital stay, leukocytopenia, acute myeloid leukemia and (or) increased use of invasive procedures including central venous catheters (CVCs) [18][19][20] . However, more details of the risk factors require further statistical analysis of the decrease in hospital-acquired BSIs in our hospital.…”

Healthcare associated infections in gynecologic oncology: clinical and economic impact

“…Previously it was believed that healthcare associated infections were limited to inpatient hospital settings; however, it has recently been demonstrated that a significant number are also experienced in the outpatient setting 12. Our data confirmed that outpatients experienced healthcare associated infections, particularly those undergoing chemotherapy 13. The Healthcare Associated Infections Prevalence Study Group reported that the most frequent types of healthcare associated infections were respiratory tract infections (21.4% pneumonia and 4.3% other lower respiratory tract infections), urinary tract infections (18.9%), surgical site infections (18.4%), bloodstream infections (10.8%), and gastrointestinal infections (8.9%).…”