An Emergent Change in Epidemiologic and Microbiological Characteristics of Bloodstream Infections in Adults With Febrile Neutropenia Resulting From Chemotherapy for Acute Leukemia and Lymphoma at Reference Centers in Chile, Ecuador, and Peru

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dc.contributor.authorRabagliati, Ricardo
dc.contributor.authorSalazar, Grace
dc.contributor.authorPerez-Lazo, Giancarlo
dc.contributor.authorIturrieta, Maria Paz
dc.contributor.authorPortillo, Diana
dc.contributor.authorSoria-Segarra, Carmen
dc.contributor.authorOjeda, Maria Jose
dc.contributor.authorFlores, Jimena
dc.contributor.authorGalarza, Margarita
dc.contributor.authorSandoval-Ahumada, Roxana
dc.contributor.authorCartes Aguilera, Pablo
dc.contributor.authorDimitrakis, Lady
dc.contributor.authorReinoso, Fabiola Avelga
dc.contributor.authorGarcia, Patricia
dc.date.accessioned2025-01-20T17:07:01Z
dc.date.available2025-01-20T17:07:01Z
dc.date.issued2024
dc.description.abstractBackground Febrile neutropenia is a life-threatening condition commonly observed in patients with hematologic malignancies. The aim of this article is to provide updated knowledge about bloodstream infections in febrile neutropenia episodes within the Andean region of Latin America.Method This retrospective study was based in 6 hospitals in Chile, Ecuador, and Peru and included adult patients with acute leukemia or lymphoma and febrile neutropenia between January 2019 and December 2020.Results Of the 416 febrile neutropenia episodes, 38.7% had a bloodstream infection, 86% of which were caused by gram-negative rods, with Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa being the most frequently identified bacteria. K pneumoniae isolates were more frequently resistant than E coli to cefotaxime (65% vs 39.6%), piperacillin-tazobactam (56.7% vs 27.1%), and imipenem (35% vs 2.1%) and were more frequently multidrug resistant (61.7% vs 12.5%). Among P aeruginosa, 26.7% were resistant to ceftazidime, piperacillin-tazobactam, and imipenem, and 23.3% were multidrug resistant. Overall 30-day mortality was 19.8%, being higher with vs without a bloodstream infection (26.7% vs 15.3%, P = .005). Fever duration was also significantly longer, as well as periods of neutropenia and length of hospital stay for patients with bloodstream infection. Additionally, the 30-day mortality rate was higher for episodes with inappropriate vs appropriate empirical antibiotic therapy (41.2% vs 26.6%, P = .139).Conclusions Considering the high rates of bacteria-resistant infection and 30-day mortality, it is imperative to establish strategies that reduce the frequency of bloodstream infections, increasing early identification of patients at higher risks of multidrug bacteria resistance, and updating existing empirical antibiotic recommendations.
dc.description.abstractThere are scarce epidemiologic data on febrile neutropenia infections in people with hematologic malignancies in Latin America. This retrospective and multicenter study offers updated knowledge regarding bloodstream infections, predominantly consisting of gram-negative rods with high rates of antibiotic resistance.
dc.description.funderPfizer
dc.fuente.origenWOS
dc.identifier.doi10.1093/ofid/ofae052
dc.identifier.issn2328-8957
dc.identifier.urihttps://doi.org/10.1093/ofid/ofae052
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/90829
dc.identifier.wosidWOS:001180496100026
dc.issue.numero3
dc.language.isoen
dc.revistaOpen forum infectious diseases
dc.rightsacceso restringido
dc.subjectbloodstream infection
dc.subjectfebrile neutropenia
dc.subjectgram-negative rods
dc.subjectmultidrug resistance
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleAn Emergent Change in Epidemiologic and Microbiological Characteristics of Bloodstream Infections in Adults With Febrile Neutropenia Resulting From Chemotherapy for Acute Leukemia and Lymphoma at Reference Centers in Chile, Ecuador, and Peru
dc.typeartículo
dc.volumen11
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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