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. 2011 May;17(5):CR304-9.
doi: 10.12659/msm.881773.

Bloodstream infections and mortality-related factors in febrile neutropenic cancer patients

Elif Sahin Horasan  1 , Gulden Ersoz, Anil Tombak, Naci Tiftik, Ali Kaya
Affiliations

Bloodstream infections and mortality-related factors in febrile neutropenic cancer patients

Elif Sahin Horasan et al. Med Sci Monit. 2011 May.

Abstract

Background: We performed a prospective observational cohort study to evaluate the causative bacteria and to identify risk factors for mortality in febrile neutropenic (FN) patients with blood stream infection (BSI).

Material/methods: We conducted a prospective data collection on all patients with bacteremia or fungemia. The patients were assigned into low-risk and high-risk groups in accordance with the Multinational Association for Supportive Care in Cancer (MASCC) Risk Index.

Results: Throughout the study period, the patients developed 420 FN episodes. Out of 420 episodes, only 90 (21.4%) were found to have bloodstream infection. The mean age of the patients was 45.6±18.4 years and 55.6% of the patients were male. A total of 98 isolates were recovered from the cases of BSI. Coagulase-negative Staphylococcus spp (CoNS) were the most common isolates overall (33.7%). There was a significant increase in the rate of gram-negative bacteria throughout the study period (p=0.028). Overall mortality was 33%. Multivariate analyses showed that MASCC risk scores (p=0.0001, OR=15.1, CI%95 4.5-50.7), ICU wards (p=0.0002, OR= 8.6, Cl%95 1.101-68,157) and CoNS (p=0.004, OR=12.12, CI%95 2.3-64.7) were independent risk factors associated with mortality. BSI due to CoNS was associated with lower mortality; however, MASCC high risk score and ICU stay were associated with higher mortality.

Conclusions: The MASCC risk-index score and emergence of CoNS in positive blood cultures are valuable tools in the management of FN.

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Figures

Figure 1
Figure 1
Percent of gram positive and gram negative bacteremia throughout the study period.
Figure 2
Figure 2
Increase in A. baumanni bacteremia throughout the study period.
See this image and copyright information in PMC

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