Pseudomonas aeruginosa Bloodstream Infections Presenting with Septic Shock in Neutropenic Cancer Patients: Impact of Empirical Antibiotic Therapy

This large, multicenter, retrospective cohort study including onco-hematological neutropenic patients with Pseudomonas aeruginosa bloodstream infection (PABSI) found that among 1213 episodes, 411 (33%) presented with septic shock. The presence of solid tumors (33.3% vs. 20.2%, p < 0.001), a high-...

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Autores: Royo-Cebrecos, Cristina, Laporte Amargós, Júlia, Peña, Marta, Ruiz, Isabel (Ruiz Camps), García Vidal, Carolina, Abdala, Edson, Oltolini, Chiara, Akova, Murat, Montejo, Miguel, Mikulska, Malgorzata, Martín Dávila, Pilar, Herrera, Fabián, Gasch, Oriol, Drgona, Lubos, Paz Morales, Hugo Manuel, Brunel, Anne Sophie, García, Estefanía, Isler, Burcu, Kern, Winfried V., Palacios Baena, Zaira R., Maestro de la Calle, Guillermo, Montero, Maria Milagro, Kanj, Souha S., Sipahi, Oguz R., Calik, Sebnem, Márquez Gómez, Ignacio, Marín, Jorge I., Gomes, Marisa Z. R., Hemmatii, Philipp, Araos, Rafael, Peghin, Maddalena, Pozo, José Luis del, Yáñez, Lucrecia, Tilley, Robert, Manzur, Adriana, Novo, Andrés, Carratalà, Jordi, Gudiol González, Carlota
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/214364
Acceso en línea:https://hdl.handle.net/2445/214364
Access Level:acceso abierto
Palabra clave:Xoc sèptic
Càncer
Septic shock
Cancer
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spelling Pseudomonas aeruginosa Bloodstream Infections Presenting with Septic Shock in Neutropenic Cancer Patients: Impact of Empirical Antibiotic TherapyRoyo-Cebrecos, CristinaLaporte Amargós, JúliaPeña, MartaRuiz, Isabel (Ruiz Camps)García Vidal, CarolinaAbdala, EdsonOltolini, ChiaraAkova, MuratMontejo, MiguelMikulska, MalgorzataMartín Dávila, PilarHerrera, FabiánGasch, OriolDrgona, LubosPaz Morales, Hugo ManuelBrunel, Anne SophieGarcía, EstefaníaIsler, BurcuKern, Winfried V.Palacios Baena, Zaira R.Maestro de la Calle, GuillermoMontero, Maria MilagroKanj, Souha S.Sipahi, Oguz R.Calik, SebnemMárquez Gómez, IgnacioMarín, Jorge I.Gomes, Marisa Z. R.Hemmatii, PhilippAraos, RafaelPeghin, MaddalenaPozo, José Luis delYáñez, LucreciaTilley, RobertManzur, AdrianaNovo, AndrésCarratalà, JordiGudiol González, CarlotaXoc sèpticCàncerSeptic shockCancerThis large, multicenter, retrospective cohort study including onco-hematological neutropenic patients with Pseudomonas aeruginosa bloodstream infection (PABSI) found that among 1213 episodes, 411 (33%) presented with septic shock. The presence of solid tumors (33.3% vs. 20.2%, p < 0.001), a high-risk Multinational Association for Supportive Care in Cancer (MASCC) index score (92.6% vs. 57.4%; p < 0.001), pneumonia (38% vs. 19.2% p < 0.001), and infection due to multidrug-resistant P. aeruginosa (MDRPA) (33.8% vs. 21.1%, p < 0.001) were statistically significantly higher in patients with septic shock compared to those without. Patients with septic shock were more likely to receive inadequate empirical antibiotic therapy (IEAT) (21.7% vs. 16.2%, p = 0.020) and to present poorer outcomes, including a need for ICU admission (74% vs. 10.5%; p < 0.001), mechanical ventilation (49.1% vs. 5.6%; p < 0.001), and higher 7-day and 30-day case fatality rates (58.2% vs. 12%, p < 0.001, and 74% vs. 23.1%, p < 0.001, respectively). Risk factors for 30-day case fatality rate in patients with septic shock were orotracheal intubation, IEAT, infection due to MDRPA, and persistent PABSI. Therapy with granulocyte colony-stimulating factor and BSI from the urinary tract were associated with improved survival. Carbapenems were the most frequent IEAT in patients with septic shock, and the use of empirical combination therapy showed a tendency towards improved survival. Our findings emphasize the need for tailored management strategies in this high-risk population.MDPI AG2024202420242024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion13 p.application/pdfhttps://hdl.handle.net/2445/214364Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.3390/microorganisms12040705Microorganisms, 2024, vol. 12, num. 4https://doi.org/10.3390/microorganisms12040705cc by (c) Royo Cebrecos, Cristina et al, 2024http://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/2143642026-05-29T05:05:01Z
dc.title.none.fl_str_mv Pseudomonas aeruginosa Bloodstream Infections Presenting with Septic Shock in Neutropenic Cancer Patients: Impact of Empirical Antibiotic Therapy
title Pseudomonas aeruginosa Bloodstream Infections Presenting with Septic Shock in Neutropenic Cancer Patients: Impact of Empirical Antibiotic Therapy
spellingShingle Pseudomonas aeruginosa Bloodstream Infections Presenting with Septic Shock in Neutropenic Cancer Patients: Impact of Empirical Antibiotic Therapy
Royo-Cebrecos, Cristina
Xoc sèptic
Càncer
Septic shock
Cancer
title_short Pseudomonas aeruginosa Bloodstream Infections Presenting with Septic Shock in Neutropenic Cancer Patients: Impact of Empirical Antibiotic Therapy
title_full Pseudomonas aeruginosa Bloodstream Infections Presenting with Septic Shock in Neutropenic Cancer Patients: Impact of Empirical Antibiotic Therapy
title_fullStr Pseudomonas aeruginosa Bloodstream Infections Presenting with Septic Shock in Neutropenic Cancer Patients: Impact of Empirical Antibiotic Therapy
title_full_unstemmed Pseudomonas aeruginosa Bloodstream Infections Presenting with Septic Shock in Neutropenic Cancer Patients: Impact of Empirical Antibiotic Therapy
title_sort Pseudomonas aeruginosa Bloodstream Infections Presenting with Septic Shock in Neutropenic Cancer Patients: Impact of Empirical Antibiotic Therapy
dc.creator.none.fl_str_mv Royo-Cebrecos, Cristina
Laporte Amargós, Júlia
Peña, Marta
Ruiz, Isabel (Ruiz Camps)
García Vidal, Carolina
Abdala, Edson
Oltolini, Chiara
Akova, Murat
Montejo, Miguel
Mikulska, Malgorzata
Martín Dávila, Pilar
Herrera, Fabián
Gasch, Oriol
Drgona, Lubos
Paz Morales, Hugo Manuel
Brunel, Anne Sophie
García, Estefanía
Isler, Burcu
Kern, Winfried V.
Palacios Baena, Zaira R.
Maestro de la Calle, Guillermo
Montero, Maria Milagro
Kanj, Souha S.
Sipahi, Oguz R.
Calik, Sebnem
Márquez Gómez, Ignacio
Marín, Jorge I.
Gomes, Marisa Z. R.
Hemmatii, Philipp
Araos, Rafael
Peghin, Maddalena
Pozo, José Luis del
Yáñez, Lucrecia
Tilley, Robert
Manzur, Adriana
Novo, Andrés
Carratalà, Jordi
Gudiol González, Carlota
author Royo-Cebrecos, Cristina
author_facet Royo-Cebrecos, Cristina
Laporte Amargós, Júlia
Peña, Marta
Ruiz, Isabel (Ruiz Camps)
García Vidal, Carolina
Abdala, Edson
Oltolini, Chiara
Akova, Murat
Montejo, Miguel
Mikulska, Malgorzata
Martín Dávila, Pilar
Herrera, Fabián
Gasch, Oriol
Drgona, Lubos
Paz Morales, Hugo Manuel
Brunel, Anne Sophie
García, Estefanía
Isler, Burcu
Kern, Winfried V.
Palacios Baena, Zaira R.
Maestro de la Calle, Guillermo
Montero, Maria Milagro
Kanj, Souha S.
Sipahi, Oguz R.
Calik, Sebnem
Márquez Gómez, Ignacio
Marín, Jorge I.
Gomes, Marisa Z. R.
Hemmatii, Philipp
Araos, Rafael
Peghin, Maddalena
Pozo, José Luis del
Yáñez, Lucrecia
Tilley, Robert
Manzur, Adriana
Novo, Andrés
Carratalà, Jordi
Gudiol González, Carlota
author_role author
author2 Laporte Amargós, Júlia
Peña, Marta
Ruiz, Isabel (Ruiz Camps)
García Vidal, Carolina
Abdala, Edson
Oltolini, Chiara
Akova, Murat
Montejo, Miguel
Mikulska, Malgorzata
Martín Dávila, Pilar
Herrera, Fabián
Gasch, Oriol
Drgona, Lubos
Paz Morales, Hugo Manuel
Brunel, Anne Sophie
García, Estefanía
Isler, Burcu
Kern, Winfried V.
Palacios Baena, Zaira R.
Maestro de la Calle, Guillermo
Montero, Maria Milagro
Kanj, Souha S.
Sipahi, Oguz R.
Calik, Sebnem
Márquez Gómez, Ignacio
Marín, Jorge I.
Gomes, Marisa Z. R.
Hemmatii, Philipp
Araos, Rafael
Peghin, Maddalena
Pozo, José Luis del
Yáñez, Lucrecia
Tilley, Robert
Manzur, Adriana
Novo, Andrés
Carratalà, Jordi
Gudiol González, Carlota
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Xoc sèptic
Càncer
Septic shock
Cancer
topic Xoc sèptic
Càncer
Septic shock
Cancer
description This large, multicenter, retrospective cohort study including onco-hematological neutropenic patients with Pseudomonas aeruginosa bloodstream infection (PABSI) found that among 1213 episodes, 411 (33%) presented with septic shock. The presence of solid tumors (33.3% vs. 20.2%, p < 0.001), a high-risk Multinational Association for Supportive Care in Cancer (MASCC) index score (92.6% vs. 57.4%; p < 0.001), pneumonia (38% vs. 19.2% p < 0.001), and infection due to multidrug-resistant P. aeruginosa (MDRPA) (33.8% vs. 21.1%, p < 0.001) were statistically significantly higher in patients with septic shock compared to those without. Patients with septic shock were more likely to receive inadequate empirical antibiotic therapy (IEAT) (21.7% vs. 16.2%, p = 0.020) and to present poorer outcomes, including a need for ICU admission (74% vs. 10.5%; p < 0.001), mechanical ventilation (49.1% vs. 5.6%; p < 0.001), and higher 7-day and 30-day case fatality rates (58.2% vs. 12%, p < 0.001, and 74% vs. 23.1%, p < 0.001, respectively). Risk factors for 30-day case fatality rate in patients with septic shock were orotracheal intubation, IEAT, infection due to MDRPA, and persistent PABSI. Therapy with granulocyte colony-stimulating factor and BSI from the urinary tract were associated with improved survival. Carbapenems were the most frequent IEAT in patients with septic shock, and the use of empirical combination therapy showed a tendency towards improved survival. Our findings emphasize the need for tailored management strategies in this high-risk population.
publishDate 2024
dc.date.none.fl_str_mv 2024
2024
2024
2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/214364
url https://hdl.handle.net/2445/214364
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.3390/microorganisms12040705
Microorganisms, 2024, vol. 12, num. 4
https://doi.org/10.3390/microorganisms12040705
dc.rights.none.fl_str_mv cc by (c) Royo Cebrecos, Cristina et al, 2024
http://creativecommons.org/licenses/by/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by (c) Royo Cebrecos, Cristina et al, 2024
http://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 13 p.
application/pdf
dc.publisher.none.fl_str_mv MDPI AG
publisher.none.fl_str_mv MDPI AG
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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