Beyond neutropenia: 14 years analysis of bloodstream infections in hematological malignancies

IF 4 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-09-01 DOI:10.1016/j.jiph.2025.102948

Aiah M. Khateb , Ahmed S. Barefah , Osman O. Radhwi , Ali Algiraigri , Esam I. Azhar

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Abstract

Background

Bloodstream infections (BSIs) are a major cause of morbidity and mortality in patients with hematological malignancies (HMs).

Methods

This 14-year retrospective study was conducted at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, from 2007 to 2021. It examined the epidemiological profile, microbial spectrum, resistance patterns, and outcomes of BSIs in HM patients. Microbial identification was based on aerobic and anaerobic blood cultures; PCR testing was used requested as needed. Statistical analysis was performed in Excel, including one-way ANOVA, Chi-square, and linear regression.

Results

Among 2112 HM patients, 296 (14 %) experienced at least one BSI episode. Incidence peaked in 2014, 2016, and 2017, with a subsequent decline possibly reflecting improved infection control. Bacterial infections comprised 90 % of cases (n = 1341), the highest was Gram-negative organisms (n = 745) such as E. coli (n = 86) and Klebsiella pneumoniae (n = 77). Gram-positive pathogens (n = 596) included coagulase-negative Staphylococci (n = 319) and Staphylococcus aureus (n = 75). Fungal infections accounted for 4 % (n = 61), primarily Candida albicans. Resistance was high (21.1 %), particularly in Enterococcus (48.9 %), Acinetobacter (45.8 %), E. coli ESBL (40.3 %), and Klebsiella pneumoniae CRE/ESBL (45 %, 32.5 %). The overall mortality was 85 %, significantly higher for resistant Klebsiella pneumoniae (100 % vs. 88.7 %, p = 0.008) and notably elevated for E. coli ESBL (94.2 % vs. 83.1 %, p = 0.063). Adults had the highest incidence. Combined aerobic (69 %) and anaerobic (31 %) cultures improved diagnostic yield, especially in polymicrobial infections.

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超越中性粒细胞减少：血液系统恶性肿瘤血液感染的14年分析

血液感染（bsi）是血液学恶性肿瘤（HMs）患者发病和死亡的主要原因。方法回顾性研究于2007年至2021年在沙特阿拉伯吉达阿卜杜勒阿齐兹国王大学医院进行。它检查了HM患者的流行病学概况，微生物谱，耐药模式和BSIs的结果。微生物鉴定是基于有氧和无氧血液培养；根据需要使用PCR检测。在Excel中进行统计分析，包括单因素方差分析、卡方分析和线性回归。结果在2112例HM患者中，296例（14% %）至少经历过一次BSI发作。发病率在2014年、2016年和2017年达到高峰，随后的下降可能反映了感染控制的改善。细菌感染由90 %的病例(n = 1341),最高的是革兰氏阴性细菌(n = 745)如大肠杆菌(n = 86)和肺炎克雷伯菌(n = 77)。革兰氏阳性病原菌（n = 596）包括凝固酶阴性葡萄球菌（n = 319）和金黄色葡萄球菌（n = 75）。真菌感染占4 % (n = 61)，以白色念珠菌为主。耐药率较高（21.1% %），特别是肠球菌（48.9% %）、不动杆菌（45.8% %）、大肠杆菌ESBL（40.3% %）和肺炎克雷伯菌CRE/ESBL（45 %,32.5 %）。总体死亡率是85 %,明显高于对耐药肺炎克雷伯菌(100 % 88.7 vs % p = 0.008)和ESBL大肠杆菌显著升高(94.2 % 83.1 vs % p = 0.063)。成人发病率最高。有氧（69 %）和厌氧（31 %）联合培养提高了诊断率，特别是在多微生物感染中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.