Characteristics and Outcomes of Bloodstream Infections in a Tertiary-Care Pediatric Hematology-Oncology Unit: A 10-Year Study

Bloodstream infections (BSIs) after chemotherapy or hematopoietic stem cell transplantation (HSCT) are a leading cause of morbidity and mortality. Data on 154 BSIs that occurred in 111 onco-hematological patients (57 hematological malignancies, 28 solid tumors, and 26 non-malignant hematological dis...

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Published in:Journal of clinical medicine 2022-02, Vol.11 (3), p.880
Main Authors: Mattei, Davide, Baretta, Valentina, Mazzariol, Annarita, Maccacaro, Laura, Balter, Rita, Zaccaron, Ada, Bonetti, Elisa, Chinello, Matteo, Vitale, Virginia, Caddeo, Giulia, Esposto, Maria Pia, Pezzella, Vincenza, Gibellini, Davide, Tridello, Gloria, Cesaro, Simone
Format: Article
Language:English
Subjects:
Age
Antibiotics
Bacteria
Bacterial infections
Blood
Catheters
Chemotherapy
Clinical medicine
Disease prevention
Epidemiology
Hematology
Hypotension
Intensive care
Leukemia
Mortality
Multidrug resistant organisms
Neutropenia
Neutrophils
Nosocomial infections
Patients
Pediatrics
Remission (Medicine)
Sepsis
Stem cell transplantation
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Summary:Bloodstream infections (BSIs) after chemotherapy or hematopoietic stem cell transplantation (HSCT) are a leading cause of morbidity and mortality. Data on 154 BSIs that occurred in 111 onco-hematological patients (57 hematological malignancies, 28 solid tumors, and 26 non-malignant hematological diseases) were retrospectively collected and analyzed. Monomicrobial Gram-positive (GP), Gram-negative (GN), and fungal BSIs accounted for 50% (77/154), 38.3% (59/144), and 3.2% (5/154) of all episodes. Polymicrobial infections were 7.8% (12/154), while mixed bacterial-fungal infections were 0.6% (1/154). The most frequent GN isolates were (46.9%), followed by (21.9%), species (18.8%), and species (6.3%). Overall, 18.8% (12/64) of GN organisms were multidrug-resistant (seven , three , and two ), whereas GP resistance to glycopeptides was observed in 1% (1/97). Initial empirical antibiotic therapy was deemed inappropriate in 12.3% of BSIs (19/154). The 30-day mortality was 7.1% (11/154), while the bacteremia-attributable mortality was 3.9% (6/154). In multivariate analysis, septic shock was significantly associated with 30-day mortality ( = 0.0001). Attentive analysis of epidemiology and continuous microbiological surveillance are essential for the appropriate treatment of bacterial infections in pediatric onco-hematological patients.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm11030880