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Pseudomonas aeruginosa Bloodstream Infections in Patients with Cancer: Differences between Patients with Hematological Malignancies and Solid Tumors

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dc.contributor.authorRoyo-Cebrecos, Cristina
dc.contributor.authorLaporte-Amargós, Julia
dc.contributor.authorPeña, Marta
dc.contributor.authorRuiz-Camps, Isabel
dc.contributor.authorPuerta-Alcalde, Pedro
dc.contributor.authorAbdala, Edson
dc.contributor.authorOltolini, Chiara
dc.contributor.authorAkova, Murat
dc.contributor.authorMontejo, Miguel
dc.contributor.authorMikulska, Malgorzata
dc.contributor.authorMartín-Dávila, Pilar
dc.contributor.authorHerrera, Fabian
dc.contributor.authorGasch, Oriol
dc.contributor.authorDrgona, Lubos
dc.contributor.authorPaz Morales, Hugo Manuel
dc.contributor.authorBrunel, Anne-Sophie
dc.contributor.authorGarcía, Estefanía
dc.contributor.authorIsler, Burcu
dc.contributor.authorKern, Winfried V.
dc.contributor.authorPalacios-Baena, Zaira R.
dc.contributor.authorMaestro de la Calle, Guillermo
dc.contributor.authorMontero, Maria Milagro
dc.contributor.authorKanj, Souha S.
dc.contributor.authorSipahi, Oguz R.
dc.contributor.authorCalik, Sebnem
dc.contributor.authorMárquez-Gómez, Ignacio
dc.contributor.authorMarin, Jorge I.
dc.contributor.authorGomes, Marisa Z.R.
dc.contributor.authorHemmatti, Philipp
dc.contributor.authorAraos Bralic, Rafael Ignacio
dc.contributor.authorPeghin, Maddalena
dc.contributor.authorPozo, José Luis del
dc.contributor.authorYáñez, Lucrecia
dc.contributor.authorTilley, Robert
dc.contributor.authorManzur, Adriana
dc.contributor.authorNovo, Andrés
dc.contributor.authorCarratalà, Jordi
dc.contributor.authorGudiol, Carlota
dc.contributor.authorIronic study group
dc.date.accessioned2023-12-06T14:28:29Z
dc.date.available2023-12-06T14:28:29Z
dc.date.issued2022
dc.description.abstractObjectives: To assess the clinical features and outcomes of Pseudomonas aeruginosa bloodstream infection (PA BSI) in neutropenic patients with hematological malignancies (HM) and with solid tumors (ST), and identify the risk factors for 30-day mortality. Methods: We performed a large multicenter, retrospective cohort study including onco-hematological neutropenic patients with PA BSI conducted across 34 centers in 12 countries (January 2006−May 2018). Episodes occurring in hematologic patients were compared to those developing in patients with ST. Risk factors associated with 30-day mortality were investigated in both groups. Results: Of 1217 episodes of PA BSI, 917 occurred in patients with HM and 300 in patients with ST. Hematological patients had more commonly profound neutropenia (0.1 × 109 cells/mm) (67% vs. 44.6%; p < 0.001), and a high risk Multinational Association for Supportive Care in Cancer (MASCC) index score (32.2% vs. 26.7%; p = 0.05). Catheter-infection (10.7% vs. 4.7%; p = 0.001), mucositis (2.4% vs. 0.7%; p = 0.042), and perianal infection (3.6% vs. 0.3%; p = 0.001) predominated as BSI sources in the hematological patients, whereas pneumonia (22.9% vs. 33.7%; p < 0.001) and other abdominal sites (2.8% vs. 6.3%; p = 0.006) were more common in patients with ST. Hematological patients had more frequent BSI due to multidrug-resistant P. aeruginosa (MDRPA) (23.2% vs. 7.7%; p < 0.001), and were more likely to receive inadequate initial antibiotic therapy (IEAT) (20.1% vs. 12%; p < 0.001). Patients with ST presented more frequently with septic shock (45.8% vs. 30%; p < 0.001), and presented worse outcomes, with increased 7-day (38% vs. 24.2%; p < 0.001) and 30-day (49% vs. 37.3%; p < 0.001) case-fatality rates. Risk factors for 30-day mortality in hematologic patients were high risk MASCC index score, IEAT, pneumonia, infection due to MDRPA, and septic shock. Risk factors for 30-day mortality in patients with ST were high risk MASCC index score, IEAT, persistent BSI, and septic shock. Therapy with granulocyte colony-stimulating factor was associated with survival in both groups. Conclusions: The clinical features and outcomes of PA BSI in neutropenic cancer patients showed some differences depending on the underlying malignancy. Considering these differences and the risk factors for mortality may be useful to optimize their therapeutic management. Among the risk factors associated with overall mortality, IEAT and the administration of granulocyte colony-stimulating factor were the only modifiable variables.
dc.description.versionVersión publicada
dc.format.extent12 p.
dc.identifier.citationRoyo-Cebrecos C, Laporte-Amargós J, Peña M, Ruiz-Camps I, Puerta-Alcalde P, Abdala E, Oltolini C, Akova M, Montejo M, Mikulska M, Martín-Dávila P, Herrera F, Gasch O, Drgona L, Morales HMP, Brunel AS, García E, Isler B, Kern WV, Palacios-Baena ZR, de la Calle GM, Montero MM, Kanj SS, Sipahi OR, Calik S, Márquez-Gómez I, Marin JI, Gomes MZR, Hemmatti P, Araos R, Peghin M, Del Pozo JL, Yáñez L, Tilley R, Manzur A, Novo A, Carratalà J, Gudiol C; IRONIC study group. Pseudomonas aeruginosa Bloodstream Infections in Patients with Cancer: Differences between Patients with Hematological Malignancies and Solid Tumors. Pathogens. 2022 Sep 30;11(10):1132. doi: 10.3390/pathogens11101132
dc.identifier.doihttps://doi.org/10.3390/pathogens11101132
dc.identifier.urihttps://repositorio.udd.cl/handle/11447/8140
dc.language.isoen
dc.subjectPseudomonas aeruginosa
dc.subjectBacteremia
dc.subjectBloodstream infection
dc.subjectCancer
dc.subjectHematologic malignancy
dc.subjectSolid tumor
dc.titlePseudomonas aeruginosa Bloodstream Infections in Patients with Cancer: Differences between Patients with Hematological Malignancies and Solid Tumors
dc.typeArticle
dcterms.accessRightsAcceso abierto
dcterms.sourcePathogens
dspace.entity.typePublication
relation.isAuthorOfPublication69e40056-7a55-41b3-8a65-05aace0e07e3
relation.isAuthorOfPublication.latestForDiscovery69e40056-7a55-41b3-8a65-05aace0e07e3

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