Risk factors for bacteremia and central line-associated blood stream infections in children with acute myelogenous leukemia: A single-institution report

2016 ◽  
Vol 64 (3) ◽  
pp. e26254 ◽  
Author(s):  
Ashley E. J. Rogers ◽  
Kristen M. Eisenman ◽  
Susan A. Dolan ◽  
Kristin M. Belderson ◽  
Jocelyn R. Zauche ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Myelogenous Leukemia ◽  
Blood Stream ◽  
Central Line ◽  
Myelogenous Leukemia ◽  
Single Institution ◽  
Blood Stream Infections ◽  
Acute Myelogenous

Characteristics of Bacteremia in Pediatric Oncology Patients Based on Pathogen Classification as Associated with the Gastrointestinal Mucosa or Skin

2015 ◽  
Vol 36 (6) ◽  
pp. 730-733 ◽  
Author(s):  
Aron Flagg ◽  
Sarah Worley ◽  
Charles B. Foster
Keyword(s):  
Pediatric Oncology ◽  
Acute Myelogenous Leukemia ◽  
Blood Stream ◽  
Infect Control Hosp ◽  
Myelogenous Leukemia ◽  
Central Catheter ◽  
Gastrointestinal Mucosa ◽  
Blood Stream Infections ◽  
Oral Flora ◽  
Acute Myelogenous

Factors favoring blood stream infections associated with gastrointestinal mucosa versus skin organisms were explored. An observed difference was attributable to bacteremia from oral flora in patients with acute myelogenous leukemia or mucositis. Our data do not support the conclusion that isolation of enteric Gram-negatives is unrelated to the central catheter.Infect Control Hosp Epidemiol 2015;00(0): 1–4

scholarly journals 116. Risk Factors and Clinical Outcomes of Carbapenem Non-Susceptible Gram-Negative Bacteremia in Patients with Acute Myelogenous Leukemia

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S89-S89
Author(s):  
Dong Hoon Shin ◽  
Kang Il Jun ◽  
Song Mi Moon ◽  
Wan Beom Park ◽  
Ji Hwan Bang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Outcomes ◽  
Acute Myelogenous Leukemia ◽  
Myelogenous Leukemia ◽  
Resistant Organism ◽  
Time Interval ◽  
Gram Negative ◽  
Gram Negative Bacteremia ◽  
Acute Myelogenous ◽  
Independent Risk Factors

Abstract Background Early administration of susceptible antibiotics is crucial in Gram-negative bacteremia (GNB), especially in immunocompromised patients. We aimed to explore risk factors and clinical outcomes of carbapenem non-susceptible (Carba-NS) GNB in patients with acute myelogenous leukemia (AML). Methods Cases of all GNB during induction or consolidation chemotherapy for AML in a 15-year period in a tertiary hospital were retrospectively reviewed. Independent risk factors for Carba-NS GNB were sought and its clinical outcomes were compared with those of carbapenem susceptible (Carba-S) GNB. Results Among 485 GNB cases from 930 patients, 440 (91%) were Carba-S and 45 (9%) were Carba-NS GNB. Frequent Carba-NS isolates were Stenotrophomonas maltophilia (n = 23), Pseudomonas aeruginosa (n = 11), and Acinetobacter baumannii (n = 10). Independent risk factors for Carba-NS GNB were carbapenem use at the onset of GNB (aOR [95% CI], 78.6 [24.4–252.8]; P < 0.001), the isolation of imipenem-resistant A. baumannii in the prior 1 year (aOR [95% CI], 14.6 [2.7–79.9]; P = 0.002), time interval from chemotherapy to GNB ≥20 days (aOR [95% CI], 4.7 [1.7–13.1]; P = 0.003), and length of hospital stay ≥30 days (aOR [95% CI], 3.4 [1.3–9.1]; P = 0.013). Except breakthrough GNBs which occurred during carbapenem treatment, the frequency of Carba-NS GNB was 48% (19/40) in cases having ≥2 risk factors other than carbapenem use. 30-day overall mortality (Carba-NS, 36% vs. Carba-S, 6%; P < 0.001) and in-hospital mortality (Carba-NS, 47% vs. Carba-S, 9%; P < 0.001) were significantly higher in Carba-NS GNB. Conclusion Carba-NS GNB in AML patients was independently associated with the use of carbapenem, the past isolation of resistant organism, and late onset of GNB, and its clinical outcomes were poorer than those of Carba-S GNB. Carba-NS organisms should be considered for antibiotic selection in AML patients having these risk factors. Disclosures All authors: No reported disclosures.

scholarly journals Results of second salvage therapy in 673 adults with acute myelogenous leukemia treated at a single institution since 2000

Cancer ◽  
2018 ◽  
Vol 124 (12) ◽  
pp. 2534-2540 ◽  
Author(s):  
Hagop M. Kantarjian ◽  
Courtney D. DiNardo ◽  
Graciela M. Nogueras-Gonzalez ◽  
Tapan M. Kadia ◽  
Elias Jabbour ◽  
...  
Keyword(s):  
Salvage Therapy ◽  
Acute Myelogenous Leukemia ◽  
Myelogenous Leukemia ◽  
Single Institution ◽  
Acute Myelogenous

scholarly journals Risk factors for and clinical outcomes of carbapenem non-susceptible gram negative bacilli bacteremia in patients with acute myelogenous leukemia

2020 ◽  
Author(s):  
Dong Hoon Shin ◽  
Dong-Yeop Shin ◽  
Chang Kyung Kang ◽  
Suhyeon Park ◽  
Jieun Park ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Outcomes ◽  
Acute Myelogenous Leukemia ◽  
Tertiary Care ◽  
Myelogenous Leukemia ◽  
Care Hospital ◽  
Gram Negative ◽  
Carbapenem Resistant ◽  
Appropriate Treatment ◽  
Acute Myelogenous

Abstract Background: Carbapenem is frequently used when gram negative bacilli (GNB) bacteremia is detected especially in neutropenic patients. Consequently, appropriate treatment could be delayed in GNB bacteremia cases involving organisms which are not susceptible to carbapenem (carba-NS), resulting in a poor clinical outcomes. Here, we explored risk factors for carba-NS GNB bacteremia and its clinical outcomes in patients with acute myelogenous leukemia (AML) that underwent chemotherapy. Methods: We reviewed all GNB bacteremia cases that occurred during induction or consolidation chemotherapy, over a 15-year period, in a tertiary-care hospital. Results: Among 489 GNB bacteremia cases from 324 patients, 45 (9.2%) were carba-NS and 444 (90.8%) were carbapenem susceptible GNB. Independent risk factors for carba-NS GNB bacteremia were: carbapenem use at bacteremia onset (adjusted odds ratio [aOR]: 91.2; 95% confidence interval [95%CI]: 29.3-284.1; P<0.001); isolation of carbapenem-resistant Acinetobacter baumannii (aOR: 19.4, 95%CI: 3.4-112.5; P=0.001) in the prior year; and days from chemotherapy to GNB bacteremia (aOR: 1.1 per day, 95%CI: 1.1-1.2; P<0.001). Carba-NS bacteremia was independently associated with in-hospital mortality (aOR: 6.6, 95%CI: 3.0-14.8; P<0.001). Conslusion: Carba-NS organisms should be considered for antibiotic selection in AML patients having these risk factors.

scholarly journals Central line-associated blood stream infections: characteristics and risk factors for mortality over a 5.5-year period

2017 ◽  
Vol 47 ◽  
pp. 646-652 ◽  
Author(s):  
Aynur ATİLLA ◽  
Zahide DOĞANAY ◽  
Hale KEFELİ ÇELİK ◽  
Mehmet Derya DEMİRAĞ ◽  
S. Sırrı KILIÇ
Keyword(s):  
Risk Factors ◽  
Blood Stream ◽  
Central Line ◽  
Blood Stream Infections

Frequency, Risk Factors, and Outcomes of Vancomycin-Resistant Enterococcus Colonization and Infection in Patients with Newly Diagnosed Acute Leukemia: Different Patterns in Patients with Acute Myelogenous and Acute Lymphoblastic Leukemia

2015 ◽  
Vol 36 (1) ◽  
pp. 47-53 ◽  
Author(s):  
Clyde D. Ford ◽  
Bert K. Lopansri ◽  
Souha Haydoura ◽  
Greg Snow ◽  
Kristin K. Dascomb ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Lymphoblastic Leukemia ◽  
Acute Leukemia ◽  
Acute Myelogenous Leukemia ◽  
Molecular Typing ◽  
Lymphoblastic Leukemia ◽  
Myelogenous Leukemia ◽  
Newly Diagnosed ◽  
Acute Myelogenous ◽  
Vancomycin Resistant

OBJECTIVETo determine the frequency, risk factors, and outcomes for vancomycin-resistant Enterococcus (VRE) colonization and infection in patients with newly diagnosed acute leukemia.DESIGNRetrospective clinical study with VRE molecular strain typing.SETTINGA regional referral center for acute leukemia.PATIENTSTwo hundred fourteen consecutive patients with newly diagnosed acute leukemia between 2006 and 2012.METHODSAll patients had a culture of first stool and weekly surveillance for VRE. Clinical data were abstracted from the Intermountain Healthcare electronic data warehouse. VRE molecular typing was performed utilizing the semi-automated DiversiLab System.RESULTSThe rate of VRE colonization was directly proportional to length of stay and was higher in patients with acute lymphoblastic leukemia. Risk factors associated with colonization include administration of corticosteroids (P=0.004) and carbapenems (P=0.009). Neither a colonized prior room occupant nor an increased unit colonization pressure affected colonization risk. Colonized patients with acute myelogenous leukemia had an increased risk of VRE bloodstream infection (BSI, P=0.002). Other risk factors for VRE BSI include severe neutropenia (P=0.04) and diarrhea (P=0.008). Fifty-eight percent of BSI isolates were identical or related by molecular typing. Eighty-nine percent of bloodstream isolates were identical or related to stool isolates identified by surveillance cultures. VRE BSI was associated with increased costs (P=0.0003) and possibly mortality.CONCLUSIONSVRE colonization has important consequences for patients with acute myelogenous leukemia undergoing induction therapy. For febrile neutropenic patients with acute myelogenous leukemia, use of empirical antibiotic regimens that avoid carbapenems and include VRE coverage may be helpful in decreasing the risks associated with VRE BSI.Infect Control Hosp Epidemiol 2015;36(1): 47–53

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