Clinical features and outcome of Aeromonas sobria bacteremia in pediatric and adult patients with hematologic malignancies: A single-center retrospective study in Peru

• Published in: PloS one 2021-08, Vol.16 (8), p.e0255910-e0255910
• Main Authors: Valcarcel, Bryan, De-la-Cruz-Ku, Gabriel, Malpica, Luis, Enriquez-Vera, Daniel
• Format: Article
• Language: English
• Subjects: Acute lymphoblastic leukemia; Acute myeloid leukemia; Adolescent; Adult; Adults; Aeromonas; Aeromonas - drug effects; Aeromonas - isolation & purification; Aeromonas sobria; Age groups; Aged; Anemia; Antiinfectives and antibacterials; Bacteremia; Bacteremia - complications; Bacteremia - microbiology; Bacteremia - mortality; Bacteremia - pathology; Biology and Life Sciences; Blood cancer; Blood diseases; Cancer; Child; Child, Preschool; Ciprofloxacin; Ciprofloxacin - pharmacology; Cross Infection - complications; Cross Infection - microbiology; Cross Infection - mortality; Cross Infection - pathology; Diagnosis; Disease; Drug Resistance, Bacterial - drug effects; Failure analysis; Female; Genetic aspects; Health aspects; Hematologic Neoplasms - complications; Hematologic Neoplasms - pathology; Hematological diseases; Hematology; Humans; Kaplan-Meier Estimate; Leukemia; Leukopenia; Lymphatic leukemia; Lymphoma; Male; Medical prognosis; Medical records; Medicine and Health Sciences; Middle Aged; Mortality; Multiple myeloma; Multiple Organ Failure; Myeloid leukemia; Nosocomial infections; Pain; Patients; Pediatrics; People and Places; Peru; Proportional Hazards Models; Regression analysis; Retrospective Studies; Sepsis; Statistical analysis; Survival; Thrombocytopenia; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0255910

Previous studies have found that healthcare-associated bacteremia (HAB) by Aeromonas species is associated with mortality. However, there is limited data on this outcome in patients with hematologic malignancies. This study aimed to identify the clinical features of patients with malignant hematologic diseases diagnosed with Aeromonas sobria bacteremia and to evaluate whether the type of bacteremia, community-acquired bacteremia (CAB) or HAB, is associated with mortality. We retrospectively reviewed the clinical records of pediatric and adult patients between January 2000 and December 2017. Clinical characteristics were compared between CAB and HAB. Additionally, we stratified based on age group. Survival outcomes were assessed with Kaplan-Meier curves and a multivariate Cox regression analysis. A total of 37 patients (median age 24 years) were identified; 23 (62%) had HAB and 14 (38%) had CAB. Overall, the most common presenting symptom was abdominal pain (41%). Acute lymphoblastic leukemia (n = 12/15, 80%) and acute myeloid leukemia (n = 8/22, 36%) were the primary hematologic malignancies in pediatric and adult patients, respectively. CAB patients had worse overall survival (OS) rates at 30 days in all (43% versus HAB 91%, p = 0.006) and adult patients (30% versus HAB 92%, p = 0.002). Cox regression analysis found that quick Sequential Organ Failure Assessment and CAB were statistically significant factors associated with mortality. Low antimicrobial-resistant was noted, except for ciprofloxacin (n = 5/37, 14%). Our study found a worse OS among patients with hematologic malignancies and CAB by Aeromonas sobria. Our results suggest that patients with CAB present with a worse disease severity. These findings should aid clinicians to determine the survival prognosis in this population.