ArticleThe Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases
Proposal of a clinical score to stratify the risk of multidrug-resistant gram-negative rods bacteremia in cancer patients.
Article in The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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3 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.
- The impact of inpatient bloodstream infections caused by antibiotic-resistant bacteria in low- and middle-income countries: A systematic review and meta-analysis.PLoS medicine · 2023Pooled it
- Multidrug-Resistant Gram-Negative Bacteremia among Pediatric Oncology Patients with Neutropenic Fever: Associated Risk Factors and Mortality Outcomes.Infection & chemotherapy · 2026Article
- Factors Associated with Gram-Negative Bacteremia and Mortality in Neutropenic Patients with Hematologic Malignancies in a High-Resistance Setting.Infectious diseases & clinical microbiology · 2022Article
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Authors and funding
11 authors at 6 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
introductionMultidrug-resistant gram-negative rods (MDR GNR) represent a growing threat for patients with cancer. Our objective was to determine the characteristics of and risk factors for MDR GNR bacteremia in patients with cancer and to develop a clinical score to predict MDR GNR bacteremia. MATERIAL AND
methodsMulticenter prospective study analyzing initial episodes of MDR GNR bacteremia. Risk factors were evaluated using a multiple logistic regression (forward-stepwise selection) analysis including variables with a p<0.10 in univariate analysis.
results394 episodes of GNR bacteremia were included, with 168 (42.6 %) being MDR GNR. Five variables were identified as independent risk factors: recent antibiotic use (OR=2.8, 95 % CI 1.7-4.6, p=0.001), recent intensive care unit admission (OR=2.9, 95 % CI 1.1-7.8, p=0.027), hospitalization ≥ 7 days prior to the episode of bacteremia (OR=3.5, 95 % CI 2-6.2, p=0.005), severe mucositis (OR=5.3, 95 % CI 1.8-15.6, p=0.002), and recent or previous colonization/infection with MDR GNR (OR=2.3, 95 % CI 1.2-4.3, p=0.028). Using a cut-off value of two points, the score had a sensitivity of 66.07 % (95 % CI 58.4-73.2 %), a specificity of 77.8 % (95 % CI 71.4-82.7 %), a positive predictive value of 68 % (95 % CI 61.9-73.4 %), and a negative predictive value of 75.9 % (95 % CI 71.6-79.7 %). The overall performance of the score was satisfactory (AUROC 0.78; 95 % CI 0.73-0.82). In the cases with one or none of the risk factors identified, the negative likelihood ratio was 0.18 and the post-test probability of having MDR GNR was 11.68 %.
conclusionsWith the growing incidence of MDR GNR as etiologic agents of bacteremia in cancer patients, the development of this score could be a potential tool for clinicians.
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