Bacteremia in patients with hematological malignancies. Analysis of risk factors, etiological agents and prognostic indicators

Livio Pagano, Evelina Tacconelli, Mario Tumbarello, Luca Laurenti, Elettra Ortu La Barbera, Andrea Antinori, Savina Caponera, Roberto Cauda, Giuseppe Leone

Research output: Contribution to journalArticle

Abstract

Background and Objective. Patients with hematological malignancies are at increased risk for developing bacteremia. No previous study has investigated the risk and prognostic indicators of bacteremia in such patients using a statistical approach. Methods. A case-control study was performed in 106 patients with hematological malignancies (group A). Two hundred and twelve patients were included as controls and divided into two groups: 106 patients with hematological malignancy without bacteremia (group B) and 106 HIV-infected patients with bacteremia (group C). Results. At univariate analysis, bacteremia risk factors in group A were: neutropenia for more than six days (p=0.03 vs. group B), central venous catheter usage (p=0.04) and absence of antibiotic prophylaxis (p=0.03). At multivariate analysis, the use of CVC and neutropenia were independent bacteremia risk factors. The most frequent etiological agents were: Staphylococcus epidermidis and Pseudomonas aeruginosa. Comparing groups A and C, the distribution of Staphylococcus spp. was different, with S. epidermidis being prevalent in hematological patients only. As regards gram-negative organisms, it is of note that no episode of NT-Salmonella bacteremia was observed in group A, Unlike group C, where they represent the second leading etiological agents. In group A, 14% of the patients died. Persistent neutropenia (p=0.01) and the presence of relapsed neoplasm (p=0.04) were prognostic indicators of bacteremia. Interpretation and Conclusions. Our findings suggest that bacteremia in patients with hematological malignancies strictly correlates with the intensity and length of neutropenia and CVC usage. Although we observed a low mortality rate, we stress that this clinical condition requires special attention from the physician, who must recognize and treat it promptly.

Original languageEnglish
Pages (from-to)415-419
Number of pages5
JournalHaematologica
Volume82
Issue number4
Publication statusPublished - Jul 1997

Fingerprint

Hematologic Neoplasms
Bacteremia
Neutropenia
Staphylococcus epidermidis
Antibiotic Prophylaxis
Central Venous Catheters
Staphylococcus
Salmonella
Pseudomonas aeruginosa
Case-Control Studies
Multivariate Analysis
HIV
Physicians
Mortality

Keywords

  • Hematological malignancy
  • Prognostic indicators
  • Risk factors

ASJC Scopus subject areas

  • Hematology

Cite this

Pagano, L., Tacconelli, E., Tumbarello, M., Laurenti, L., Barbera, E. O. L., Antinori, A., ... Leone, G. (1997). Bacteremia in patients with hematological malignancies. Analysis of risk factors, etiological agents and prognostic indicators. Haematologica, 82(4), 415-419.

Bacteremia in patients with hematological malignancies. Analysis of risk factors, etiological agents and prognostic indicators. / Pagano, Livio; Tacconelli, Evelina; Tumbarello, Mario; Laurenti, Luca; Barbera, Elettra Ortu La; Antinori, Andrea; Caponera, Savina; Cauda, Roberto; Leone, Giuseppe.

In: Haematologica, Vol. 82, No. 4, 07.1997, p. 415-419.

Research output: Contribution to journalArticle

Pagano, L, Tacconelli, E, Tumbarello, M, Laurenti, L, Barbera, EOL, Antinori, A, Caponera, S, Cauda, R & Leone, G 1997, 'Bacteremia in patients with hematological malignancies. Analysis of risk factors, etiological agents and prognostic indicators', Haematologica, vol. 82, no. 4, pp. 415-419.
Pagano, Livio ; Tacconelli, Evelina ; Tumbarello, Mario ; Laurenti, Luca ; Barbera, Elettra Ortu La ; Antinori, Andrea ; Caponera, Savina ; Cauda, Roberto ; Leone, Giuseppe. / Bacteremia in patients with hematological malignancies. Analysis of risk factors, etiological agents and prognostic indicators. In: Haematologica. 1997 ; Vol. 82, No. 4. pp. 415-419.
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AU - Tacconelli, Evelina

AU - Tumbarello, Mario

AU - Laurenti, Luca

AU - Barbera, Elettra Ortu La

AU - Antinori, Andrea

AU - Caponera, Savina

AU - Cauda, Roberto

AU - Leone, Giuseppe

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N2 - Background and Objective. Patients with hematological malignancies are at increased risk for developing bacteremia. No previous study has investigated the risk and prognostic indicators of bacteremia in such patients using a statistical approach. Methods. A case-control study was performed in 106 patients with hematological malignancies (group A). Two hundred and twelve patients were included as controls and divided into two groups: 106 patients with hematological malignancy without bacteremia (group B) and 106 HIV-infected patients with bacteremia (group C). Results. At univariate analysis, bacteremia risk factors in group A were: neutropenia for more than six days (p=0.03 vs. group B), central venous catheter usage (p=0.04) and absence of antibiotic prophylaxis (p=0.03). At multivariate analysis, the use of CVC and neutropenia were independent bacteremia risk factors. The most frequent etiological agents were: Staphylococcus epidermidis and Pseudomonas aeruginosa. Comparing groups A and C, the distribution of Staphylococcus spp. was different, with S. epidermidis being prevalent in hematological patients only. As regards gram-negative organisms, it is of note that no episode of NT-Salmonella bacteremia was observed in group A, Unlike group C, where they represent the second leading etiological agents. In group A, 14% of the patients died. Persistent neutropenia (p=0.01) and the presence of relapsed neoplasm (p=0.04) were prognostic indicators of bacteremia. Interpretation and Conclusions. Our findings suggest that bacteremia in patients with hematological malignancies strictly correlates with the intensity and length of neutropenia and CVC usage. Although we observed a low mortality rate, we stress that this clinical condition requires special attention from the physician, who must recognize and treat it promptly.

AB - Background and Objective. Patients with hematological malignancies are at increased risk for developing bacteremia. No previous study has investigated the risk and prognostic indicators of bacteremia in such patients using a statistical approach. Methods. A case-control study was performed in 106 patients with hematological malignancies (group A). Two hundred and twelve patients were included as controls and divided into two groups: 106 patients with hematological malignancy without bacteremia (group B) and 106 HIV-infected patients with bacteremia (group C). Results. At univariate analysis, bacteremia risk factors in group A were: neutropenia for more than six days (p=0.03 vs. group B), central venous catheter usage (p=0.04) and absence of antibiotic prophylaxis (p=0.03). At multivariate analysis, the use of CVC and neutropenia were independent bacteremia risk factors. The most frequent etiological agents were: Staphylococcus epidermidis and Pseudomonas aeruginosa. Comparing groups A and C, the distribution of Staphylococcus spp. was different, with S. epidermidis being prevalent in hematological patients only. As regards gram-negative organisms, it is of note that no episode of NT-Salmonella bacteremia was observed in group A, Unlike group C, where they represent the second leading etiological agents. In group A, 14% of the patients died. Persistent neutropenia (p=0.01) and the presence of relapsed neoplasm (p=0.04) were prognostic indicators of bacteremia. Interpretation and Conclusions. Our findings suggest that bacteremia in patients with hematological malignancies strictly correlates with the intensity and length of neutropenia and CVC usage. Although we observed a low mortality rate, we stress that this clinical condition requires special attention from the physician, who must recognize and treat it promptly.

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