Publications

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

Title:

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

Year:

2022

Type of item:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Language:

Inglese

Referee:

Sì

Name of journal:

JOURNAL OF CLINICAL MEDICINE

ISSN of journal:

2077-0383

N° Volume:

11

Number or Folder:

3

Page numbers:

880-891

Keyword:

Gram-negative; Gram-positive; bacteremia; bloodstream infection; empirical antibiotic therapy; multidrug resistance organism; neutropenia; neutropenic fever

Short description of contents:

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 Escherichia coli (46.9%), followed by Pseudomonas aeruginosa (21.9%), Klebsiella species (18.8%), and Enterobacter species (6.3%). Overall, 18.8% (12/64) of GN organisms were multidrug-resistant (seven Escherichia coli, three Klebsiella pneumoniae, and two Enterobacter cloacae), 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 (p = 0.0001). Attentive analysis of epidemiology and continuous microbiological surveillance are essential for the appropriate treatment of bacterial infections in pediatric onco-hematological patients.

Product ID:

124981

Handle IRIS:

11562/1057976

Last Modified:

November 30, 2022

Bibliographic citation:

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, Characteristics and Outcomes of Bloodstream Infections in a Tertiary-Care Pediatric Hematology–Oncology Unit: A 10-Year Study «JOURNAL OF CLINICAL MEDICINE» , vol. 11 , n. 3 , 2022 , pp. 880-891

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