Dissecting bloodstream infections in febrile neutropenic patients with hematological malignancies, a decade-long single center retrospective observational study (2009–2019)
<h3>Background </h3><p dir="ltr">The use of ill-suited antibiotics is a significant risk factor behind the increase in the mortality, morbidity, and economic burden for patients who are under treatment for hematological malignancy (HM) and bloodstream infections (BSI). Su...
محفوظ في:
| المؤلف الرئيسي: | |
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| مؤلفون آخرون: | , , , , , , , , , |
| منشور في: |
2023
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| الموضوعات: | |
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إضافة وسم
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| _version_ | 1864513510239633408 |
|---|---|
| author | Halima El Omri (14778790) |
| author2 | Regina Padmanabhan (14231606) Ruba Y. Taha (19206124) Nancy Kassem (3517106) Hesham Elsabah (8984069) Anil Yousaf Ellahie (8984072) Antonio J.J. Santimano (19206127) Muna A. Al-Maslamani (11721413) Ali S. Omrani (9590116) Adel Elomri (8984063) Abdelfatteh El Omri (18278683) |
| author2_role | author author author author author author author author author author |
| author_facet | Halima El Omri (14778790) Regina Padmanabhan (14231606) Ruba Y. Taha (19206124) Nancy Kassem (3517106) Hesham Elsabah (8984069) Anil Yousaf Ellahie (8984072) Antonio J.J. Santimano (19206127) Muna A. Al-Maslamani (11721413) Ali S. Omrani (9590116) Adel Elomri (8984063) Abdelfatteh El Omri (18278683) |
| author_role | author |
| dc.creator.none.fl_str_mv | Halima El Omri (14778790) Regina Padmanabhan (14231606) Ruba Y. Taha (19206124) Nancy Kassem (3517106) Hesham Elsabah (8984069) Anil Yousaf Ellahie (8984072) Antonio J.J. Santimano (19206127) Muna A. Al-Maslamani (11721413) Ali S. Omrani (9590116) Adel Elomri (8984063) Abdelfatteh El Omri (18278683) |
| dc.date.none.fl_str_mv | 2023-11-13T18:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1016/j.jiph.2023.11.017 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Dissecting_bloodstream_infections_in_febrile_neutropenic_patients_with_hematological_malignancies_a_decade-long_single_center_retrospective_observational_study_2009_2019_/26363275 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Cardiovascular medicine and haematology Clinical sciences Health sciences Public health Febrile neutropenia Blood stream infection Hematological malignancies Drug resistance |
| dc.title.none.fl_str_mv | Dissecting bloodstream infections in febrile neutropenic patients with hematological malignancies, a decade-long single center retrospective observational study (2009–2019) |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3>Background </h3><p dir="ltr">The use of ill-suited antibiotics is a significant risk factor behind the increase in the mortality, morbidity, and economic burden for patients who are under treatment for hematological malignancy (HM) and bloodstream infections (BSI). Such unfitting treatment choices intensify the evolution of resistant variants which is a public health concern due to possible healthcare-associated infection spread to the general population. Hence, this study aims to evaluate antibiograms of patients with BSI and risk factors associated with septicemia. </p><h3>Methods</h3><p dir="ltr"> A total of 1166 febrile neutropenia episodes (FNE) among 513 patients with HM from the National Center for Cancer Care and Research (NCCCR), Qatar, during 2009–2019 were used for this study. The socio-demographic, clinical, microbial, and anti-microbial data retrieved from the patient’s health records were used. </p><h3>Results</h3><p dir="ltr"> We analyzed the sensitivity of gram-negative and gram-positive bacilli reported in HM-FN-BSI patients. Out of the total 512 microorganisms isolated, 416 (81%) were gram-negative bacteria (GNB), 76 (15%) were gram-positive bacteria (GPB) and 20 (4%) were fungi. Furthermore, in 416 GNB, 298 (71.6%) were Enterobacteriaceae sp. among which 121 (41%) were ESBL (Extended Spectrum Beta-Lactamase) resistant to Cephalosporine third generation and Piperacillin-Tazobactam, 54 (18%) were Carbapenem-resistant or multidrug-resistant organism (MDRO). It's noteworthy that the predominant infectious agents in our hospital include E. coli, Klebsiella species, and P. aeruginosa. Throughout the study period, the mortality rate due to BSI was 23%. Risk factors that show a significant correlation with death are age, disease status, mono or polymicrobial BSI and septic shock. Conclusion Decision pertaining to the usage of antimicrobials for HM-FN-BSI patients is a critical task that relies on the latest pattern of prevalence, treatment resistance, and clinical outcomes. Analysis of the antibiogram of HM-FN-BSI patients in Qatar calls for a reconsideration of currently followed empirical antibiotic therapy towards better infection control and antimicrobial stewardship.</p><h2>Other Information</h2><p dir="ltr">Published in: Journal of Infection and Public Health<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.jiph.2023.11.017" target="_blank">https://dx.doi.org/10.1016/j.jiph.2023.11.017</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_f41cc9cbd51a2e5d972d89a94a331808 |
| identifier_str_mv | 10.1016/j.jiph.2023.11.017 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/26363275 |
| publishDate | 2023 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Dissecting bloodstream infections in febrile neutropenic patients with hematological malignancies, a decade-long single center retrospective observational study (2009–2019)Halima El Omri (14778790)Regina Padmanabhan (14231606)Ruba Y. Taha (19206124)Nancy Kassem (3517106)Hesham Elsabah (8984069)Anil Yousaf Ellahie (8984072)Antonio J.J. Santimano (19206127)Muna A. Al-Maslamani (11721413)Ali S. Omrani (9590116)Adel Elomri (8984063)Abdelfatteh El Omri (18278683)Biomedical and clinical sciencesCardiovascular medicine and haematologyClinical sciencesHealth sciencesPublic healthFebrile neutropeniaBlood stream infectionHematological malignanciesDrug resistance<h3>Background </h3><p dir="ltr">The use of ill-suited antibiotics is a significant risk factor behind the increase in the mortality, morbidity, and economic burden for patients who are under treatment for hematological malignancy (HM) and bloodstream infections (BSI). Such unfitting treatment choices intensify the evolution of resistant variants which is a public health concern due to possible healthcare-associated infection spread to the general population. Hence, this study aims to evaluate antibiograms of patients with BSI and risk factors associated with septicemia. </p><h3>Methods</h3><p dir="ltr"> A total of 1166 febrile neutropenia episodes (FNE) among 513 patients with HM from the National Center for Cancer Care and Research (NCCCR), Qatar, during 2009–2019 were used for this study. The socio-demographic, clinical, microbial, and anti-microbial data retrieved from the patient’s health records were used. </p><h3>Results</h3><p dir="ltr"> We analyzed the sensitivity of gram-negative and gram-positive bacilli reported in HM-FN-BSI patients. Out of the total 512 microorganisms isolated, 416 (81%) were gram-negative bacteria (GNB), 76 (15%) were gram-positive bacteria (GPB) and 20 (4%) were fungi. Furthermore, in 416 GNB, 298 (71.6%) were Enterobacteriaceae sp. among which 121 (41%) were ESBL (Extended Spectrum Beta-Lactamase) resistant to Cephalosporine third generation and Piperacillin-Tazobactam, 54 (18%) were Carbapenem-resistant or multidrug-resistant organism (MDRO). It's noteworthy that the predominant infectious agents in our hospital include E. coli, Klebsiella species, and P. aeruginosa. Throughout the study period, the mortality rate due to BSI was 23%. Risk factors that show a significant correlation with death are age, disease status, mono or polymicrobial BSI and septic shock. Conclusion Decision pertaining to the usage of antimicrobials for HM-FN-BSI patients is a critical task that relies on the latest pattern of prevalence, treatment resistance, and clinical outcomes. Analysis of the antibiogram of HM-FN-BSI patients in Qatar calls for a reconsideration of currently followed empirical antibiotic therapy towards better infection control and antimicrobial stewardship.</p><h2>Other Information</h2><p dir="ltr">Published in: Journal of Infection and Public Health<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.jiph.2023.11.017" target="_blank">https://dx.doi.org/10.1016/j.jiph.2023.11.017</a></p>2023-11-13T18:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.jiph.2023.11.017https://figshare.com/articles/journal_contribution/Dissecting_bloodstream_infections_in_febrile_neutropenic_patients_with_hematological_malignancies_a_decade-long_single_center_retrospective_observational_study_2009_2019_/26363275CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/263632752023-11-13T18:00:00Z |
| spellingShingle | Dissecting bloodstream infections in febrile neutropenic patients with hematological malignancies, a decade-long single center retrospective observational study (2009–2019) Halima El Omri (14778790) Biomedical and clinical sciences Cardiovascular medicine and haematology Clinical sciences Health sciences Public health Febrile neutropenia Blood stream infection Hematological malignancies Drug resistance |
| status_str | publishedVersion |
| title | Dissecting bloodstream infections in febrile neutropenic patients with hematological malignancies, a decade-long single center retrospective observational study (2009–2019) |
| title_full | Dissecting bloodstream infections in febrile neutropenic patients with hematological malignancies, a decade-long single center retrospective observational study (2009–2019) |
| title_fullStr | Dissecting bloodstream infections in febrile neutropenic patients with hematological malignancies, a decade-long single center retrospective observational study (2009–2019) |
| title_full_unstemmed | Dissecting bloodstream infections in febrile neutropenic patients with hematological malignancies, a decade-long single center retrospective observational study (2009–2019) |
| title_short | Dissecting bloodstream infections in febrile neutropenic patients with hematological malignancies, a decade-long single center retrospective observational study (2009–2019) |
| title_sort | Dissecting bloodstream infections in febrile neutropenic patients with hematological malignancies, a decade-long single center retrospective observational study (2009–2019) |
| topic | Biomedical and clinical sciences Cardiovascular medicine and haematology Clinical sciences Health sciences Public health Febrile neutropenia Blood stream infection Hematological malignancies Drug resistance |