ArticleEuropean journal of medical research2025
Mucosal barrier injury as an independent risk factor for laboratory-confirmed bloodstream infection in patients with hematological malignancies: a real-world study.
Article in European journal of medical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Harnessing next-generation microbial diagnostics to optimize infection management in immunocompromised hosts.Current opinion in infectious diseases · 2026Review
- A machine learning-driven multitask framework for antibiotic resistance prediction in Escherichia coli, Klebsiella pneumoniae, and Enterobacter cloacae bloodstream infections among hematological malignancy patients.Antimicrobial resistance and infection control · 2026Article
- Comprehensive management of hemodialysis catheter-related bloodstream infections: a narrative review.Frontiers in cellular and infection microbiology · 2026Review
- Who is at risk? Clinical features and a predictive model for 30-day mortality in hematologic patients with enterococcal bloodstream infection.Frontiers in cellular and infection microbiology · 2026Article
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11 authors.
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Abstract
backgroundHematological malignancy (HM) patients are at high risk of bloodstream infections (BSIs) due to chemotherapy-induced mucosal barrier injury (MBI), invasive procedures, and prolonged antimicrobial exposure. While conventional nosocomial infection paradigms emphasize catheter-related biofilms, emerging evidence highlights the role of disrupted oral/gut microbiomes in bacterial translocation. This study aimed to identify risk factors for bacteremia secondary to MBI following chemotherapy in patients with HM.
methodsA single-center, retrospective analysis of 72 HM patients, including 24 with mucosal barrier injury laboratory-confirmed bloodstream infection (MBI-LCBI), 22 with non-MBI-LCBI, and 26 controls without BSIs, was conducted. Microbiology profiles, resistance patterns, and risk factors for BSIs were analyzed.
resultsAll MBI-LCBI patients had significantly longer neutropenia duration than non-MBI-LCBI patients did (median 6.5 vs. 3.0 days, p = 0.013). Multivariate analysis identified MBI as an independent risk factor for BSIs (OR = 11.467, 95% CI1.287-102.170). Prolonged hospitalization (> 30 days) was associated with BSI occurrence (OR = 6.758, 95% CI 1.102-41.440) and neutropenia duration (OR = 1.112, 95% CI 1.014-1.220). Significant differences in pathogen distribution were observed between groups: Escherichia coli, Klebsiella pneumoniae, and viridans group streptococci predominated in the MBI-LCBI group, whereas Pseudomonas aeruginosa and Staphylococcus spp. were common in the non-MBI-LCBI group. Carbapenem resistance remained below 20% for key gram-negative pathogens.
conclusionsMBI is an independent risk factor for BSI in HM patients, highlighting the need for targeted mucosal protection strategies. MBI-LCBI pathogens primarily originate from the gut/oral flora, and are distinct from catheter-related infections. Carbapenems are recommended for empirical therapy, yet resistance surveillance remains essential.
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