Mortality burden related to infection with carbapenem-resistant Gram-negative bacteria among haematological cancer patients: a retrospective cohort study
Mortality burden related to infection with carbapenem-resistant Gram-negative bacteria among haematological cancer patients: a retrospective cohort study
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DOI：
10.1093/jac/dkv218
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发表时间：
2015-11-01
影响因子：
5.2
通讯作者：
Paul, Mical
中科院分区：
文献类型：
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作者：
Andria, Nizar;Henig, Oryan;Paul, Mical
目的：耐碳青霉烯革兰氏阴性菌（CRGNB）引起临床挑战。我们试图估计CRGNB在血液学癌症患者中的死亡率负担。方法：回顾性队列研究。我们纳入了2008年至2014年间在血肿瘤科/骨髓移植科住院接受化疗的革兰氏阴性需氧菌血症的成年患者。我们比较了CRGNB和碳青霉烯敏感革兰氏阴性菌血症（CSGNB）患者。主要终点为14天全因死亡率。此外，我们评估了1年生存率。进行多变量logistic回归分析和校正Cox回归分析。分析调整为CRGNB菌血症倾向。结果：该队列主要包括急性白血病的年轻患者（平均年龄50.1岁）（264/423,62.4%），菌血症发病时绝对中性粒细胞中位数为0x10(9)/L。与CSGNB相比，CRGNB患者未经调整的14天死亡率更高[45.6%（47/103）对15% (48/320)]
Objectives: Carbapenem-resistant Gram-negative bacteria (CRGNB) pose a clinical challenge. We attempted to estimate the mortality burden of CRGNB among haematological cancer patients.Methods: This was a retrospective cohort study. We included adult patients hospitalized in the haemato-oncological/bone marrow transplantation departments for chemotherapy, between 2008 and 2014, with Gram-negative aerobic bacteraemia. We compared patients with CRGNB and carbapenem-susceptible Gram-negative bacteraemia (CSGNB). The primary outcome was 14 day all-cause mortality. In addition, we assessed 1 year survival. Multivariable logistics regression analysis and adjusted Cox regression analysis were conducted. Analyses were adjusted to the propensity for CRGNB bacteraemia.Results: The cohort included mostly young patients (mean age 50.1 years) with acute leukaemia (264/423, 62.4%) and the median absolute neutrophil count at bacteraemia onset was 0x10(9)/L. The unadjusted 14 day mortality rate was higher for patients with CRGNB compared with CSGNB [45.6% (47/103) versus 15% (48/320), respectively (P