Clinical characteristics of bloodstream infections in adult patients with solid tumours and a nomogram for mortality prediction: a 5-year case-controlled retrospective study in a tertiary-level hospital
BackgroundBloodstream infections (BSIs) are one of the leading causes of death in cancer patients. Nevertheless, the risk factors of BSIs in solid tumors have rarely been ascertained adequately.MethodsWe conducted a single-center case-controlled retrospective study from 2017 to 2021 among adults wit...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-08-01
|
| Series: | Frontiers in Cellular and Infection Microbiology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcimb.2023.1228401/full |
| _version_ | 1797751805771251712 |
|---|---|
| author | Lijuan Xue Lijuan Xue Ying Zhu Mingxi Zong Panpan Jiao Jianguo Fu Xian-Ming Liang Xian-Ming Liang Juan Zhan Juan Zhan |
| author_facet | Lijuan Xue Lijuan Xue Ying Zhu Mingxi Zong Panpan Jiao Jianguo Fu Xian-Ming Liang Xian-Ming Liang Juan Zhan Juan Zhan |
| author_sort | Lijuan Xue |
| collection | DOAJ |
| description | BackgroundBloodstream infections (BSIs) are one of the leading causes of death in cancer patients. Nevertheless, the risk factors of BSIs in solid tumors have rarely been ascertained adequately.MethodsWe conducted a single-center case-controlled retrospective study from 2017 to 2021 among adults with solid tumors in a tertiary-level hospital. The BSIs and control group were matched by the propensity score matching method. We found independent risk factors of occurrence and death of BSIs using univariate and multivariate regression analysis. Additionally, a nomogram was constructed to predict the risk of mortality in BSIs.ResultsOf 602 patients with solid tumors in the study period, 186 had BSIs and 416 had non-BSIs. The incidence of BSIs was 2.0/1,000 admissions (206/102,704), and the 30-day mortality rate was 18.8% (35/186). Compared to the control group, the BSIs had longer hospital stays (24.5 days vs. 20.0 days), and higher frequency complicating with organ failure (10.5% vs. 2.4%), nephropathy (19.6% vs. 3.8%), comorbidities≥3 (35.5% vs. 20.0%), and liver-biliary-pancreatic infections (15.6% vs. 5.3%) (all P<0.001). Among the 186 patients with BSIs, 35 died within 30 days after BSIs. Gram-negative bacteria were the most frequent microorganisms (124/192, 64.6%). Liver cancer, organ failure, a high level of lactate dehydrogenase and septic shock were the independent hazardous factors for death of BSIs. What’s more, a nomogram was constructed to predict the 30-day survival rate of BSIs, which was proved to have good accuracy (AUC: 0.854; 95% confidence interval: 0.785~0923) and consistency.ConclusionBeing aware of the risk factors of BSIs redounds to take preventive measures to reduce the incidence and death of BSIs. |
| first_indexed | 2024-03-12T16:54:58Z |
| format | Article |
| id | doaj.art-b74f4c07567a4d1c9e27c1d6340d5850 |
| institution | Directory Open Access Journal |
| issn | 2235-2988 |
| language | English |
| last_indexed | 2024-03-12T16:54:58Z |
| publishDate | 2023-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cellular and Infection Microbiology |
| spelling | doaj.art-b74f4c07567a4d1c9e27c1d6340d58502023-08-08T09:41:36ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882023-08-011310.3389/fcimb.2023.12284011228401Clinical characteristics of bloodstream infections in adult patients with solid tumours and a nomogram for mortality prediction: a 5-year case-controlled retrospective study in a tertiary-level hospitalLijuan Xue0Lijuan Xue1Ying Zhu2Mingxi Zong3Panpan Jiao4Jianguo Fu5Xian-Ming Liang6Xian-Ming Liang7Juan Zhan8Juan Zhan9Department of Oncology Medicine, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, ChinaSchool of Medicine, Xiamen University, Xiamen, ChinaSchool of Medicine, Xiamen University, Xiamen, ChinaSchool of Medicine, Xiamen University, Xiamen, ChinaSchool of Pharmacy, Xiamen University, Xiamen, ChinaDepartment of Nosocomial Infection and Preventive Health Care, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, ChinaCenter of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, ChinaInstitute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, ChinaDepartment of Oncology Medicine, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, ChinaSchool of Medicine, Xiamen University, Xiamen, ChinaBackgroundBloodstream infections (BSIs) are one of the leading causes of death in cancer patients. Nevertheless, the risk factors of BSIs in solid tumors have rarely been ascertained adequately.MethodsWe conducted a single-center case-controlled retrospective study from 2017 to 2021 among adults with solid tumors in a tertiary-level hospital. The BSIs and control group were matched by the propensity score matching method. We found independent risk factors of occurrence and death of BSIs using univariate and multivariate regression analysis. Additionally, a nomogram was constructed to predict the risk of mortality in BSIs.ResultsOf 602 patients with solid tumors in the study period, 186 had BSIs and 416 had non-BSIs. The incidence of BSIs was 2.0/1,000 admissions (206/102,704), and the 30-day mortality rate was 18.8% (35/186). Compared to the control group, the BSIs had longer hospital stays (24.5 days vs. 20.0 days), and higher frequency complicating with organ failure (10.5% vs. 2.4%), nephropathy (19.6% vs. 3.8%), comorbidities≥3 (35.5% vs. 20.0%), and liver-biliary-pancreatic infections (15.6% vs. 5.3%) (all P<0.001). Among the 186 patients with BSIs, 35 died within 30 days after BSIs. Gram-negative bacteria were the most frequent microorganisms (124/192, 64.6%). Liver cancer, organ failure, a high level of lactate dehydrogenase and septic shock were the independent hazardous factors for death of BSIs. What’s more, a nomogram was constructed to predict the 30-day survival rate of BSIs, which was proved to have good accuracy (AUC: 0.854; 95% confidence interval: 0.785~0923) and consistency.ConclusionBeing aware of the risk factors of BSIs redounds to take preventive measures to reduce the incidence and death of BSIs.https://www.frontiersin.org/articles/10.3389/fcimb.2023.1228401/fullbloodstream infectionsmortalitynomogramrisk factorssolid tumors |
| spellingShingle | Lijuan Xue Lijuan Xue Ying Zhu Mingxi Zong Panpan Jiao Jianguo Fu Xian-Ming Liang Xian-Ming Liang Juan Zhan Juan Zhan Clinical characteristics of bloodstream infections in adult patients with solid tumours and a nomogram for mortality prediction: a 5-year case-controlled retrospective study in a tertiary-level hospital Frontiers in Cellular and Infection Microbiology bloodstream infections mortality nomogram risk factors solid tumors |
| title | Clinical characteristics of bloodstream infections in adult patients with solid tumours and a nomogram for mortality prediction: a 5-year case-controlled retrospective study in a tertiary-level hospital |
| title_full | Clinical characteristics of bloodstream infections in adult patients with solid tumours and a nomogram for mortality prediction: a 5-year case-controlled retrospective study in a tertiary-level hospital |
| title_fullStr | Clinical characteristics of bloodstream infections in adult patients with solid tumours and a nomogram for mortality prediction: a 5-year case-controlled retrospective study in a tertiary-level hospital |
| title_full_unstemmed | Clinical characteristics of bloodstream infections in adult patients with solid tumours and a nomogram for mortality prediction: a 5-year case-controlled retrospective study in a tertiary-level hospital |
| title_short | Clinical characteristics of bloodstream infections in adult patients with solid tumours and a nomogram for mortality prediction: a 5-year case-controlled retrospective study in a tertiary-level hospital |
| title_sort | clinical characteristics of bloodstream infections in adult patients with solid tumours and a nomogram for mortality prediction a 5 year case controlled retrospective study in a tertiary level hospital |
| topic | bloodstream infections mortality nomogram risk factors solid tumors |
| url | https://www.frontiersin.org/articles/10.3389/fcimb.2023.1228401/full |
| work_keys_str_mv | AT lijuanxue clinicalcharacteristicsofbloodstreaminfectionsinadultpatientswithsolidtumoursandanomogramformortalitypredictiona5yearcasecontrolledretrospectivestudyinatertiarylevelhospital AT lijuanxue clinicalcharacteristicsofbloodstreaminfectionsinadultpatientswithsolidtumoursandanomogramformortalitypredictiona5yearcasecontrolledretrospectivestudyinatertiarylevelhospital AT yingzhu clinicalcharacteristicsofbloodstreaminfectionsinadultpatientswithsolidtumoursandanomogramformortalitypredictiona5yearcasecontrolledretrospectivestudyinatertiarylevelhospital AT mingxizong clinicalcharacteristicsofbloodstreaminfectionsinadultpatientswithsolidtumoursandanomogramformortalitypredictiona5yearcasecontrolledretrospectivestudyinatertiarylevelhospital AT panpanjiao clinicalcharacteristicsofbloodstreaminfectionsinadultpatientswithsolidtumoursandanomogramformortalitypredictiona5yearcasecontrolledretrospectivestudyinatertiarylevelhospital AT jianguofu clinicalcharacteristicsofbloodstreaminfectionsinadultpatientswithsolidtumoursandanomogramformortalitypredictiona5yearcasecontrolledretrospectivestudyinatertiarylevelhospital AT xianmingliang clinicalcharacteristicsofbloodstreaminfectionsinadultpatientswithsolidtumoursandanomogramformortalitypredictiona5yearcasecontrolledretrospectivestudyinatertiarylevelhospital AT xianmingliang clinicalcharacteristicsofbloodstreaminfectionsinadultpatientswithsolidtumoursandanomogramformortalitypredictiona5yearcasecontrolledretrospectivestudyinatertiarylevelhospital AT juanzhan clinicalcharacteristicsofbloodstreaminfectionsinadultpatientswithsolidtumoursandanomogramformortalitypredictiona5yearcasecontrolledretrospectivestudyinatertiarylevelhospital AT juanzhan clinicalcharacteristicsofbloodstreaminfectionsinadultpatientswithsolidtumoursandanomogramformortalitypredictiona5yearcasecontrolledretrospectivestudyinatertiarylevelhospital |