ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2025
Clinical outcomes in patients with cancer and Gram-negative bloodstream infection: impact of carbapenem resistance.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo describe the outcome of cancer patients who present bloodstream infections (BSIs) by Gram-negative bacteria (GNB) and to analyze the impact of carbapenem resistance.
methodsA retrospective study from 2021 to 2023 at a tertiary care oncologic center in Mexico. The study describes demographic, clinical, and microbiological characteristics in oncological patients with GNB-BSI.
resultsDuring the study period, 1348 episodes of bacteremia were included. There were 703 women (52.1%), with a mean age of 50.5 ± 16.3 years. Five hundred thirty-six (39.7%) events were reported in patients with hematological malignancies (HM) and 814 (60.3%) in patients with solid tumors, having differences between both groups in age, gender, neutropenia, and type of BSI. Polymicrobial bacteremia was documented in 111 patients; 1468 GNB were identified. Nine hundred forty-five were classified as susceptible (64.4%), 417 (28.4%) were 3rd generation cephalosporins-resistant (C3R), and 106 (7.2%) were carbapenem-resistant (CR). CR episodes were most frequent in patients with HM, with severe neutropenia, and with > 2 previous episodes of BSI. Mortality at 30 days for the whole group was 21.1% and 37.5% for patients with CR strains. Multivariate analysis for 30-day mortality revealed that age > 60 years, severe neutropenia, bloodstream infection (BSI) other than catheter-related, polymicrobial BSI, ICU admission, CR strains, and inappropriate antimicrobial treatment were identified as risk factors.
conclusionsOncology patients, particularly those with HM, are a high-risk group for CR-GNB. These patients have a high mortality. Appropriate antimicrobial treatment is crucial for reducing mortality.
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