Cancer Management and Research (Dec 2020)
Analysis of Risk Factors and Clinical Indicators in Bloodstream Infections Among Patients with Hematological Malignancy
Abstract
Yating Ma,1,2 Shijian Wang,2 Ming Yang,3 Jinfeng Bao,1 Chengbin Wang1,2 1Department of Clinical Laboratory, The PLA General Hospital, Beijing 100853, People’s Republic of China; 2Nankai University School of Medicine, Nankai University, Tianjin 300071, People’s Republic of China; 3Department of Laboratory Medicine, The Third Xiangya Hospital of Central South University, Changsha 410013, People’s Republic of ChinaCorrespondence: Chengbin Wang Email [email protected]: The incidence of bloodstream infection (BSI) is more common in patients with hematological malignancy. It is important to distinguish infectious episodes from noninfectious episodes. The present study was aimed to describe the epidemiology, clinical indexes, and antibiotic use for in-hospital bloodstream infections of hematological malignancy patients.Patients and Methods: Single-center retrospective research was performed on hematological malignancy patients admitted to our hospital from July 2015 to March 2018. Laboratory and clinical information from 322 febrile patients were acquired. These episodes were divided by blood culture results into two groups: 1) blood culture positive-group, 2) blood culture negative-group.Results: In the 322 febrile cases, 81 (25.2%) patients were blood culture positive, and among them, Gram-negative (G-) bacteria (51.9%) were more isolated than Gram-positive (G+) bacteria (32.1%) and fungi (7.4%). Gram-negative bacteria were more likely to have drug resistance than G+ bacteria. Independent risk factors revealed that patients with complications, high levels of procalcitonin (PCT), glucose, interleukin-6 (IL-6), and d-dimer (D-D), and low concentration of albumin were correlated with the occurrence of BSI. PCT, IL-6 and D-D performed well in differentiating the positive group from the negative group. Moreover, IL-6 and D-D showed excellent performance in differentiating G- and G+ groups, with the areas under the curve all above 0.8.Conclusion: We analyzed the risk factors for BSI in patients with hematological malignancy, the distribution of bacteria, antibiotic resistance, and the changes in clinical parameters. This single-center retrospective study may provide clinicians insight into the diagnosis and treatment of BSI.Keywords: bacteremia, hematological malignancy, risk factors, interleukin-6, D-dimer
