Adam G Stewart, Felicity Edwards, Kevin B Laupland
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引用次数: 0
Abstract
Background: Invasive infection may be the first prompt to investigate the occult presence of a plasma cell neoplasm. The objective of this study was to quantify the risk for subsequent diagnosis of a plasma cell neoplasm following bloodstream infection (BSI).
Methods: Statewide population-based surveillance was conducted from January 1 2000 - December 31 2019. Statewide databases were used to identify patients with incident plasma cell neoplasms diagnosed within 1-year following a BSI diagnosis.
Results: A cohort of 90 individuals who had BSI within the year preceding diagnosis of plasma cell neoplasm and 95 753 patients with BSI without this malignancy were included. The time to diagnose a plasma cell neoplasm was a median 123 (31-221) days after index BSI. The overall incidence of plasma cell neoplasms among those with incident BSI was 93.9 per 100 000 population annually. Among the study population, development of a BSI was associated with a 13-fold increased risk for diagnosis of plasma cell neoplasm (IRR; 12.9; 95% CI, 10.3-15.8; p < 0.001). The increased risk following BSI was elevated for both sexes, with a magnitude of risk higher for females (IRR; 14.0; 95% CI, 9.8-19.4). Streptococcus pneumoniae BSI was associated with the highest risk for subsequent diagnosis of a plasma cell neoplasm (IRR 46.9; 95% CI; 26.2-77.4).
Conclusions: The presence of a BSI, particularly with S. pneumoniae, is a marker for occult plasma cell neoplasms in a small but significant number of patients. Further studies are warranted to identify occult neoplastic disease investigation strategies for patients with incident BSIs.
期刊介绍:
Transplant Infectious Disease has been established as a forum for presenting the most current information on the prevention and treatment of infection complicating organ and bone marrow transplantation. The point of view of the journal is that infection and allograft rejection (or graft-versus-host disease) are closely intertwined, and that advances in one area will have immediate consequences on the other. The interaction of the transplant recipient with potential microbial invaders, the impact of immunosuppressive strategies on this interaction, and the effects of cytokines, growth factors, and chemokines liberated during the course of infections, rejection, or graft-versus-host disease are central to the interests and mission of this journal.
Transplant Infectious Disease is aimed at disseminating the latest information relevant to the infectious disease complications of transplantation to clinicians and scientists involved in bone marrow, kidney, liver, heart, lung, intestinal, and pancreatic transplantation. The infectious disease consequences and concerns regarding innovative transplant strategies, from novel immunosuppressive agents to xenotransplantation, are very much a concern of this journal. In addition, this journal feels a particular responsibility to inform primary care practitioners in the community, who increasingly are sharing the responsibility for the care of these patients, of the special considerations regarding the prevention and treatment of infection in transplant recipients. As exemplified by the international editorial board, articles are sought throughout the world that address both general issues and those of a more restricted geographic import.