| Title: |
P-2264. Epidemiology and Outcomes of Bacteremia in Neutropenic Patients: A Changing Scenario over Time |
| Authors: |
Herrera, Fabián; Torres, Diego; Laborde, Ana; Tula, Lucas; Mañez, Noelia; Suchowiercha, Nadia; Berruezo, Lorena; Pereyra, María L; Benso, José; Nenna, Andrea; González Ibáñez, María L; Lambert, Sandra; Barcan, Laura; Rossi, Inés Roccia; Fernández, Ailén; Gago, Rocío; Fernández, Verónica; Soto, Vanesa; Grippo, Natalin; Pennini, Magdalena; Blanco, Miriam; Visús, Mariángeles; Reynaldi, Mariana; Carbone, Ruth; Azula, Natalia; Chaves, María Laura; Pasteran, Fernando; Corso, Alejandra; Rapoport, Melina; Carena, Alberto |
| Source: |
Open Forum Infectious Diseases ; volume 12, issue Supplement_1 ; ISSN 2328-8957 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2025 |
| Description: |
Background The epidemiology of bacteremia (B) in neutropenic patients (NP) may differ according to the geographic region or country and can change over time. The growing rate of multidrug-resistant gram-negative bacilli (MDR-GNB) is usually associated with higher mortality. Methods Prospective multicenter study. All the first episodes of B in adult NP with hematologic malignancies were included in 9 centers in Argentina, from May 2014 to December 2023. They were divided in three periods: May 2014-June 2017 (P1), July 2017-June 2020 (P2), and July 2020-December 2023 (P3). Epidemiological, clinical and treatment characteristics, as well as 30-day infection-related mortality of B episodes were compared among the periods. Results One thousand three hundred thirty B episodes were included (P1=411, P2=513, and P3=406). Most patients presented high-risk neutropenia (P1=88.3% vs. P2=90.4% vs. P3=90.3%, p=0.50). Septic shock at presentation was P1=21.9% vs. P2=14.8% vs. P3=21.3%, p=0.008. GNB was the leading cause of B, especially in the third period (63.4% vs. 65.5% vs. 79.6%, p< 0.0001). E. coli, Klebsiella spp., and P. aeruginosa were the most prevalent microorganisms, with no differences among the periods. MDR-GNB were more frequent in P1 and P3 compared with P2: 31.6% vs. 31.7% vs. 25.6%, p=0.02. Resistance mechanisms in P1 vs. P2 vs. P3 were as follows: extended-spectrum beta-lactamase production, 26.3% vs. 19.9% vs. 23.5%, p=0.18; KPC production, 7.7% vs. 9.5% vs. 5%, p=0.07; OXA-48 production, 1.5% vs. 0% vs. 1.9%, p=0.05, and MBL production, 0% vs. 0.9% vs. 7.1%, p< 0.0001. Appropriated antibiotic therapy (AT) was higher in P2 and P3 compared with P1: 85.4% vs. 86.1% vs.78.1%, p=0.002. Thirty-day infection-related mortality was P1=16% vs. P2=6.4% vs. P3=9.6%, p< 0.0001. Conclusion Both GNB and MDR-GNB were the leading cause of B, with a significant increase in the last three years. A change in carbapenemase type has been observed, with a significant rise in MBL, which presents ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1093/ofid/ofae631.2417 |
| Availability: |
https://doi.org/10.1093/ofid/ofae631.2417; https://academic.oup.com/ofid/article-pdf/12/Supplement_1/ofae631.2417/61675665/ofae631.2417.pdf |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.513D6FCA |
| Database: |
BASE |