Bloodstream gram-negative bacterial infections in adult patients with leukemia: A retrospective review of medical records in a tertiary care hospital in Western Saudi Arabia
Background: Patients with neutropenic cancers are at high risk of acquiring infections, especially if on chemotherapy. Gram-negative bacterial infections are associated with high mortality. This study aimed to assess clinical characteristics, outcomes, and epidemiology of gram-negative bacterial (GN...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-10-01
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| Series: | Journal of Infection and Public Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1876034123002459 |
| _version_ | 1797690190235435008 |
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| author | Reyan Merdad Almuhanad Alyami Ahmed Basalim Abdulrahman Alzahrani Ahmed Aldainiy Abdullah Awadh Enas Ghulam Fayssal Farahat |
| author_facet | Reyan Merdad Almuhanad Alyami Ahmed Basalim Abdulrahman Alzahrani Ahmed Aldainiy Abdullah Awadh Enas Ghulam Fayssal Farahat |
| author_sort | Reyan Merdad |
| collection | DOAJ |
| description | Background: Patients with neutropenic cancers are at high risk of acquiring infections, especially if on chemotherapy. Gram-negative bacterial infections are associated with high mortality. This study aimed to assess clinical characteristics, outcomes, and epidemiology of gram-negative bacterial (GNB) bloodstream infections (BSI) in adult patients with leukemia. Methods: This single-center, retrospective study included 102 adult patients diagnosed with leukemia between 2017 and 2019. The patients’ demographics, infection diagnosis, leukemia diagnosis, comorbidities, and infection outcomes were collected from electronic medical records. Results: The most common GNB were Klebsiella pneumoniae (33.3 %), Pseudomonas aeruginosa (23.5 %), and Escherichia coli (17.6 %). Additionally, 36.7 % of infections were multidrug resistant. The most common comorbidities were cardiovascular diseases (36.7 %), diabetes mellitus (33.3 %), and liver diseases (24.1 %). GNB-infected patients had a higher mortality than noninfected patients (35.3 % and 11.8 %, respectively, p = 0.005). In a multivariable analysis, patients with acute myeloid leukemia and acute lymphoid leukemia were significantly more likely to acquire GNB BSI (p = 0.01), while patients with chronic myelogenous leukemia and chronic lymphocytic leukemia had a lower likelihood of developing GNB BSI. In addition, low hemoglobin level was an independent risk factor of GNB BSI (p = 0.001). Chemotherapeutic agents showed an association with increased risk of GNB BSI. Conclusions: Patients with acute leukemia and low hemoglobin levels have increased risk of GNB BSI, which was associated with increased mortality. Prospective studies are needed to further assess the effect of co-morbidities and chemotherapy medications on the occurrence of GNB BSI according to the type of leukemia. |
| first_indexed | 2024-03-12T01:57:01Z |
| format | Article |
| id | doaj.art-3bc2418e30314861902e3dcc64569133 |
| institution | Directory Open Access Journal |
| issn | 1876-0341 |
| language | English |
| last_indexed | 2024-03-12T01:57:01Z |
| publishDate | 2023-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Infection and Public Health |
| spelling | doaj.art-3bc2418e30314861902e3dcc645691332023-09-08T04:33:06ZengElsevierJournal of Infection and Public Health1876-03412023-10-01161015251530Bloodstream gram-negative bacterial infections in adult patients with leukemia: A retrospective review of medical records in a tertiary care hospital in Western Saudi ArabiaReyan Merdad0Almuhanad Alyami1Ahmed Basalim2Abdulrahman Alzahrani3Ahmed Aldainiy4Abdullah Awadh5Enas Ghulam6Fayssal Farahat7College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi ArabiaCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi ArabiaCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi ArabiaCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi ArabiaCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi ArabiaKing Abdullah International Medical Research Center, Saudi Arabia; Basic Medical Sciences, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Saudi ArabiaKing Abdullah International Medical Research Center, Saudi Arabia; Basic Science Department, College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Saudi ArabiaKing Abdullah International Medical Research Center, Saudi Arabia; College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; Community and Public Health, Infection Prevention and Control Program, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia; Department of Community Medicine and Public Health, College of Medicine, Menoufia University, Egypt; Corresponding author at: Community and Public Health, Infection Prevention and Control Program, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.Background: Patients with neutropenic cancers are at high risk of acquiring infections, especially if on chemotherapy. Gram-negative bacterial infections are associated with high mortality. This study aimed to assess clinical characteristics, outcomes, and epidemiology of gram-negative bacterial (GNB) bloodstream infections (BSI) in adult patients with leukemia. Methods: This single-center, retrospective study included 102 adult patients diagnosed with leukemia between 2017 and 2019. The patients’ demographics, infection diagnosis, leukemia diagnosis, comorbidities, and infection outcomes were collected from electronic medical records. Results: The most common GNB were Klebsiella pneumoniae (33.3 %), Pseudomonas aeruginosa (23.5 %), and Escherichia coli (17.6 %). Additionally, 36.7 % of infections were multidrug resistant. The most common comorbidities were cardiovascular diseases (36.7 %), diabetes mellitus (33.3 %), and liver diseases (24.1 %). GNB-infected patients had a higher mortality than noninfected patients (35.3 % and 11.8 %, respectively, p = 0.005). In a multivariable analysis, patients with acute myeloid leukemia and acute lymphoid leukemia were significantly more likely to acquire GNB BSI (p = 0.01), while patients with chronic myelogenous leukemia and chronic lymphocytic leukemia had a lower likelihood of developing GNB BSI. In addition, low hemoglobin level was an independent risk factor of GNB BSI (p = 0.001). Chemotherapeutic agents showed an association with increased risk of GNB BSI. Conclusions: Patients with acute leukemia and low hemoglobin levels have increased risk of GNB BSI, which was associated with increased mortality. Prospective studies are needed to further assess the effect of co-morbidities and chemotherapy medications on the occurrence of GNB BSI according to the type of leukemia.http://www.sciencedirect.com/science/article/pii/S1876034123002459HemoglobinLeukemiaGram-negativeBloodstream infections |
| spellingShingle | Reyan Merdad Almuhanad Alyami Ahmed Basalim Abdulrahman Alzahrani Ahmed Aldainiy Abdullah Awadh Enas Ghulam Fayssal Farahat Bloodstream gram-negative bacterial infections in adult patients with leukemia: A retrospective review of medical records in a tertiary care hospital in Western Saudi Arabia Journal of Infection and Public Health Hemoglobin Leukemia Gram-negative Bloodstream infections |
| title | Bloodstream gram-negative bacterial infections in adult patients with leukemia: A retrospective review of medical records in a tertiary care hospital in Western Saudi Arabia |
| title_full | Bloodstream gram-negative bacterial infections in adult patients with leukemia: A retrospective review of medical records in a tertiary care hospital in Western Saudi Arabia |
| title_fullStr | Bloodstream gram-negative bacterial infections in adult patients with leukemia: A retrospective review of medical records in a tertiary care hospital in Western Saudi Arabia |
| title_full_unstemmed | Bloodstream gram-negative bacterial infections in adult patients with leukemia: A retrospective review of medical records in a tertiary care hospital in Western Saudi Arabia |
| title_short | Bloodstream gram-negative bacterial infections in adult patients with leukemia: A retrospective review of medical records in a tertiary care hospital in Western Saudi Arabia |
| title_sort | bloodstream gram negative bacterial infections in adult patients with leukemia a retrospective review of medical records in a tertiary care hospital in western saudi arabia |
| topic | Hemoglobin Leukemia Gram-negative Bloodstream infections |
| url | http://www.sciencedirect.com/science/article/pii/S1876034123002459 |
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