Isfahan University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
Prospective Analysis of Febrile Neutropenia Patients With Bacteraemia: The Results of an International Id–Iri Study Publisher Pubmed



Erdem H1, 2 ; Kocoglu E3 ; Ankarali H4 ; Elsokkary R5 ; Hakamifard A6, 7 ; Karaali R8 ; Kulzhanova S9 ; Elkholy A10 ; Tehrani HA11 ; Khedr R12 ; Kayakalem A13 ; Pandak N14 ; Caglasonmezer M15 ; Nizamuddin S16 Show All Authors
Authors
  1. Erdem H1, 2
  2. Kocoglu E3
  3. Ankarali H4
  4. Elsokkary R5
  5. Hakamifard A6, 7
  6. Karaali R8
  7. Kulzhanova S9
  8. Elkholy A10
  9. Tehrani HA11
  10. Khedr R12
  11. Kayakalem A13
  12. Pandak N14
  13. Caglasonmezer M15
  14. Nizamuddin S16
  15. Berkcam H17
  16. Guner R13
  17. Elkholy JA18
  18. Llopis F19
  19. Marino A20
  20. Stebel R21
  21. Szabo BG22
  22. Belitova M23
  23. Fadel E24
  24. Yetisyigit T24
  25. Cag Y25
  26. Alkan S26
  27. Kayaaslan B13
  28. Oncu S27
  29. Ozdemir M28
  30. Yilmaz M29
  31. Isik AC30
  32. Baskol D31
  33. Sincan G32
  34. Cascio A33
  35. Ozerbalin S34
  36. Korkmaz N35
  37. Ripon RK36
  38. Abbas S37
  39. Dumitru IM38
  40. Eserkarlidag G39
  41. Lanzafame M40
  42. Rafey A37
  43. Raza A37
  44. Sipahi OR31
  45. Darazam IA41
  46. Elbahr U1
  47. Erdem I42
  48. Ergen P25
  49. Bilir C43, 44
  50. Caskurlu H25
  51. Erdem A45
  52. Makek MJ46
  53. Altindis M47
  54. Lakatos B22
  55. Luca CM48
  56. Yilmaz EM49
  57. Nsutebu E50
  58. Cakmak R29
  59. Sirmatel F51
Show Affiliations
Authors Affiliations
  1. 1. Department of Infectious Diseases, Bahrain Oncology Centre, King Hamad University Hospital, Al Sayh, Bahrain
  2. 2. Department of Infectious Diseases & Clinical Microbiology, Gulhane School of Medicine, Turkish Health Sciences University, Ankara, Turkey
  3. 3. Department of Microbiology and Clinical Microbiology, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey
  4. 4. Department of Biostatistics and Medical Informatics, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey
  5. 5. Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
  6. 6. Infectious Diseases and Tropical Medicine Research Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  7. 7. Department of Infectious Diseases, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  8. 8. Department of Infectious Diseases & Clinical Microbiology, Cerrahpasa School of Medicine, Istanbul, Turkey
  9. 9. Department of Infectious Diseases, Astana Medical University, Nur-Sultan, Kazakhstan
  10. 10. Department of Clinical Pathology, Faculty of Medicine, Cairo University, Giza, Egypt
  11. 11. Department of Haematology and Medical Oncology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  12. 12. Department of Paediatric Oncology, National Cancer Institute–Cairo University, Children Cancer Hospital Egypt, Cairo, Egypt
  13. 13. Department of Infectious Diseases & Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
  14. 14. The Royal Hospital, Muscat, Oman
  15. 15. Department of Infectious Diseases & Clinical Microbiology, Hacettepe School of Medicine, Hacettepe University, Ankara, Turkey
  16. 16. Section of Microbiology, Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
  17. 17. Department of Infectious Diseases and Clinical Microbiology, Antalya Education and Research Hospital, Antalya, Turkey
  18. 18. Department of Anaesthesia, Pain Management, Cairo University Hospital, Cairo, Egypt
  19. 19. Emergency Department, Bellvitge University Hospital, l'Hospitalet de Llobregat, Barcelona, Spain
  20. 20. Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, ARNAS Garibaldi Hospital, University of Catania, Catania, Italy
  21. 21. Department of Infectious Diseases, University Hospital Brno and Faculty of Medicine, Masaryk University, Czech Republic
  22. 22. South Pest Central Hospital, National Institute of Haematology and Infectious Diseases, Budapest, Hungary
  23. 23. Medical University–Sofia, Department of Anaesthesiology and Intensive Care, University Hospital ‘Queen Giovanna’ ISUL, EAD, Sofia, Bulgaria
  24. 24. Department of Oncology, Bahrain Oncology Centre, King Hamad University Hospital, Busaiteen, Bahrain
  25. 25. Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey
  26. 26. Department of Infectious Diseases and Clinical Microbiology, Onsekiz Mart University School of Medicine, Canakkale, Turkey
  27. 27. Department of Infectious Diseases & Clinical Microbiology, School of Medicine, Adnan Menderes University, Aydin, Turkey
  28. 28. Department of Medical Microbiology, Necmettin Erbakan University, Konya, Turkey
  29. 29. Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, School of Medicine, Turkey
  30. 30. Department of Internal Medicine, Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
  31. 31. Department of Infectious Diseases & Clinical Microbiology, Ege School of Medicine, Izmir, Turkey
  32. 32. Department of Haematology, School of Medicine, Ataturk University, Erzurum, Turkey
  33. 33. Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), Infectious Disease Unit, Policlinico ‘P. Giaccone’, University of Palermo, Italy
  34. 34. Department of Infectious Diseases and Clinical Microbiology, Firat University, School of Medicine, Elazig, Turkey
  35. 35. Department of Infectious Diseases and Clinical Microbiology, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
  36. 36. Department of Public Health and Informatics, Jahangirnagar University, Dhaka, Savar, Bangladesh
  37. 37. Department of Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
  38. 38. Clinical Infectious Diseases Hospital Constanta, Ovidius University of Constanta, Romania
  39. 39. Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Elazig Fethi Sekin City Hospital, Elazig, Turkey
  40. 40. S.Maria Della Misericordia Hospital, Rovigo, Italy
  41. 41. Infectious Diseases and Tropical Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  42. 42. Namik Kemal University, Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Tekirdag, Turkey
  43. 43. Department of Oncology, Istinye University, VMMedical Park Pendik Hospital, Istanbul, Turkey
  44. 44. Sakarya University Faculty of Medicine Department of Medical Oncology, Sakarya, Turkey
  45. 45. Department of Pathology, Ataturk Sanatoryum Training and Research Hospital, Ankara, Turkey
  46. 46. University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
  47. 47. Department of Microbiology, Sakarya University Faculty of Medicine, Sakarya, Turkey
  48. 48. St. Parascheva Clinical Hospital of Infectious Diseases, Iasi, Romania
  49. 49. Department of Infectious Diseases & Clinical Microbiology, Samsun Training and Research Hospital, Samsun, Turkey
  50. 50. Tropical and Infectious Diseases Division, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
  51. 51. Department of Infectious Diseases & Clinical Microbiology, School of Medicine, Abant Izzet Baysal University, Bolu, Turkey

Source: International Journal of Antimicrobial Agents Published:2023


Abstract

Objectives: Bacteraemia during the course of neutropenia is often fatal. We aimed to identify factors predicting mortality to have an insight into better clinical management. Methods: The study has a prospective, observational design using pooled data from febrile neutropenia patients with bacteraemia in 41 centres in 16 countries. Polymicrobial bacteraemias were excluded. It was performed through the Infectious Diseases–International Research Initiative platform between 17 March 2021 and June 2021. Univariate analysis followed by a multivariate binary logistic regression model was used to determine independent predictors of 30-d in-hospital mortality (sensitivity, 81.2%; specificity, 65%). Results: A total of 431 patients were enrolled, and 85 (19.7%) died. Haematological malignancies were detected in 361 (83.7%) patients. Escherichia coli (n = 117, 27.1%), Klebsiellae (n = 95, 22% %), Pseudomonadaceae (n = 63, 14.6%), Coagulase-negative Staphylococci (n = 57, 13.2%), Staphylococcus aureus (n = 30, 7%), and Enterococci (n = 21, 4.9%) were the common pathogens. Meropenem and piperacillin-tazobactam susceptibility, among the isolated pathogens, were only 66.1% and 53.6%, respectively. Pulse rate (odds ratio [OR], 1.018; 95% confidence interval [CI], 1.002–1.034), quick SOFA score (OR, 2.857; 95% CI, 2.120–3.851), inappropriate antimicrobial treatment (OR, 1.774; 95% CI, 1.011–3.851), Gram-negative bacteraemia (OR, 2.894; 95% CI, 1.437–5.825), bacteraemia of non-urinary origin (OR, 11.262; 95% CI, 1.368–92.720), and advancing age (OR, 1.017; 95% CI, 1.001–1.034) were independent predictors of mortality. Bacteraemia in our neutropenic patient population had distinctive characteristics. The severity of infection and the way to control it with appropriate antimicrobials, and local epidemiological data, came forward. Conclusions: Local antibiotic susceptibility profiles should be integrated into therapeutic recommendations, and infection control and prevention measures should be prioritised in this era of rapidly increasing antibiotic resistance. © 2023 Elsevier Ltd and International Society of Antimicrobial Chemotherapy