Evidence map›Paper›PMID 39115709›Full record

Observational studySupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2024

Mucositis-associated bloodstream infections in adult haematology patients with fever during neutropenia: risk factors and the impact of mucositis severity.

Nick A de Jonge, Jeroen J W M Janssen, Paula Ypma, Alexandra H E Herbers, Arne de Kreuk, Wies Vasmel, Jody M W van den Ouweland, Aart Beeker, Otto Visser, Sonja Zweegman and 3 more

Registry-linked trialAbstract readObservational StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02149329 (Short Versus Extended Antibiotic Treatment With a Carbapenem for High-risk Febrile Neutropenia in Hematology Patients With Fever of Unknown Origin), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02149329 phase4completednot on this map

Short Versus Extended Antibiotic Treatment With a Carbapenem for High-risk Febrile Neutropenia in Hematology Patients With Fever of Unknown Origin: a Randomized Multicenter Non-inferiority Trial.

TypeinterventionalSponsorAmsterdam UMC, location VUmcRan2014 to 2019Enrolled276ConditionsFebrile Neutropenia, Hematological MalignancyArmsDiscontinuation of imipenem-cilastatin or meropenem
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Nick A de JongeDepartment of Haematology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands. ni.dejonge@amsterdamumc.nl.ORCID http://orcid.org/0000-0002-9901-0887
Jeroen J W M JanssenDepartment of Haematology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.ORCID http://orcid.org/0000-0001-9567-1955
Paula YpmaDepartment of Haematology, HAGA Hospital, Els-Borst-Eilersplein 275, 2545 AA, The Hague, the Netherlands.ORCID http://orcid.org/0000-0003-1250-7979
Alexandra H E HerbersDepartment of Haematology and Oncology, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223 GZ, Hertogenbosch, Netherlands.ORCID http://orcid.org/0000-0002-9476-1622
Arne de KreukDepartment of Internal Medicine, OLVG, Jan Tooropstraat 164, 1061 AE, Amsterdam, the Netherlands.ORCID http://orcid.org/0000-0002-9715-9063
Wies VasmelDepartment of Internal Medicine, OLVG, Jan Tooropstraat 164, 1061 AE, Amsterdam, the Netherlands.
Jody M W van den OuwelandDepartment of Clinical Chemistry, Canisius-Wilhelmina Hospital, Weg Door Jonkerbos 100, 6532 SZ, Nijmegen, The Netherlands.ORCID http://orcid.org/0000-0003-0605-7756
Aart BeekerDepartment of Internal Medicine, Spaarne Gasthuis, Spaarnepoort 1, 2134 TM, Hoofddorp, the Netherlands.ORCID http://orcid.org/0000-0003-4133-769X
Otto VisserDepartment of Medicine, Isala, Dokter Van Heesweg 2, 8025 AB, Zwolle, the Netherlands.ORCID http://orcid.org/0000-0003-1496-1817
Sonja ZweegmanDepartment of Haematology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.ORCID http://orcid.org/0000-0002-5011-1820
Nicole M A BlijlevensDepartment of Haematology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, the Netherlands.ORCID http://orcid.org/0000-0002-1801-2072
Michiel A van AgtmaelDepartment of Internal Medicine, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.ORCID http://orcid.org/0000-0002-7966-6934
Jonne J SikkensDepartment of Internal Medicine, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.ORCID http://orcid.org/0000-0001-5481-5596

Funding

Fonds NutsOhra 1302-002ZonMw 836011030
6 · The paper itself

Abstract

purposeHaematology patients with high-risk neutropenia are prone to mucosal-barrier injury-associated laboratory-confirmed bloodstream infections (MBI-LCBI). We assessed risk factors for MBI-LCBI including candidaemia in neutropenic haematology patients with fever.

methodsThis prospective observational study was performed in six dedicated haematology units in the Netherlands. Eligible haematology patients had neutropenia < 500/mL for ≥ 7 days and had fever. MBI-LCBIs were classified according to Centers for Disease Control (CDC) definitions and were followed until the end of neutropenia > 500/mL or discharge.

resultsWe included 416 patients from December 2014 until August 2019. We observed 63 MBI-LCBIs. Neither clinical mucositis scores nor the blood level of citrulline at fever onset was associated with MBI-LCBI. In the multivariable analysis, MASCC-score (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.05 to 1.29 per point decrease), intensive chemotherapy (OR 3·81, 95% CI 2.10 to 6.90) and Pichia kudriavzevii (formerly Candida krusei) colonisation (OR 5.40, 95% CI 1.75 to 16.7) were retained as risk factors for MBI-LCBI, while quinolone use seemed protective (OR 0.42, 95% CI 0.20 to 0.92). Citrulline level (OR 1.57, 95% CI 1.07 to 2.31 per µmol/L decrease), active chronic obstructive pulmonary disease (OR 15.4, 95% CI 1.61 to 14.7) and colonisation with fluconazole-resistant Candida (OR 8.54, 95% CI 1.51 to 48.4) were associated with candidaemia.

conclusionIn haematology patients with fever during neutropenia, hypocitrullinaemia at fever onset was associated with candidaemia, but not with bacterial MBI-LCBI. Patients with intensive chemotherapy with a low MASCC-score and colonisation with Pichia kudriavzevii had the highest risk of MBI-LCBI.

trial registrationClinicalTrials.gov (NCT02149329) at 19-NOV-2014.

Indexed as

FeverMucositisNeutropeniaAdultAgedCandidemiaFemaleHematologic NeoplasmsHumansMaleMiddle AgedNetherlandsProspective StudiesRisk FactorsSeverity of Illness IndexBacteremiaCandidemiaChemotherapyFeverMucositisNeutropeniaSepsisStem cell transplantationTyphlitis

Identifiers

PMID39115709
PMCPMC11310222

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.