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Shifting trends in bloodstream infection-causing microorganisms and their clinical impact in patients with haematologic malignancies in South Korea: A propensity score-matched study

Authors
 Heekang Choi  ;  Min Hyuk Choi  ;  Dokyun Kim  ;  Kyoung Hwa Lee  ;  Seok Hoon Jeong 
Citation
 INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS, Vol.64(2) : 107212, 2024-08 
Journal Title
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS
ISSN
 0924-8579 
Issue Date
2024-08
MeSH
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bacteremia* / epidemiology ; Bacteremia* / microbiology ; Bacteremia* / mortality ; Female ; Hematologic Neoplasms* / complications ; Hematologic Neoplasms* / microbiology ; Humans ; Incidence ; Klebsiella pneumoniae / drug effects ; Klebsiella pneumoniae / isolation & purification ; Klebsiella pneumoniae / pathogenicity ; Male ; Middle Aged ; Propensity Score* ; Republic of Korea / epidemiology ; Retrospective Studies ; Risk Factors ; Staphylococcus / drug effects ; Staphylococcus / isolation & purification ; Staphylococcus / pathogenicity ; Young Adult
Keywords
Antimicrobial resistance ; Bloodstream infection ; Carbapenem resistance ; Haematologic malignancy ; Risk assessment
Abstract
Background: This study aimed to identify recent trends in the epidemiology of bloodstream infection (BSI)-causing microorganisms among patients with haematologic malignancies (HMs) between 2011 and 2021, and to determine their impact on patient outcomes. Methods: This retrospective study included 6792 patients with HMs, of whom 1308 (19.3%) developed BSI within 1 y of diagnosis. The incidence of BSI-causing microorganisms was determined, and a propensity score-matched study was performed to identify risk factors for 28-d all-cause mortality in patients with HM. Results: A total of 6792 patients with HMs were enrolled. The cumulative incidence of BSI and neutropenia was significantly higher in the acute myeloid leukaemia and acute lymphoblastic leukaemia groups compared to other groups, and neutropenia and type of HMs were risk factors for the development of BSI. The annual incidence of coagulase-negative staphylococci (CoNS)-BSI decreased significantly (P < 0.001), whereas Klebsiella pneumoniae-BSI increased (P = 0.01). Carbapenem nonsusceptibility rates in K. pneumoniae isolates increased from 0.0% to 76.5% (P < 0.001). BSI caused by K. pneumoniae (adjusted odds ratio 2.17; 95% confidence interval 1.12–4.21) was associated with higher 28-d all-cause mortality compared to that caused by CoNS (adjusted odds ratio 0.86; 95% confidence interval 0.48–1.55). Conclusion: The pathogenic spectrum of BSI-causing bacteria in patients with HMs gradually shifted from Gram-positive to Gram-negative, especially from CoNS to K. pneumoniae. Considering that K. pneumoniae-BSI had a significantly higher 28-d mortality rate than CoNS-BSI, this evolving trend could adversely impact the clinical outcomes of patients with HMs.
Full Text
https://www.sciencedirect.com/science/article/pii/S0924857924001304
DOI
10.1016/j.ijantimicag.2024.107212
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dokyun(김도균) ORCID logo https://orcid.org/0000-0002-0348-5440
Lee, Kyoung Hwa(이경화) ORCID logo https://orcid.org/0000-0003-0033-1398
Jeong, Seok Hoon(정석훈) ORCID logo https://orcid.org/0000-0001-9290-897X
Choi, Min Hyuk(최민혁) ORCID logo https://orcid.org/0000-0001-9801-9874
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/200372
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