Predictive and risk factor analysis for bloodstream infection in high-risk hematological patients with febrile neutropenia: post-hoc analysis from a prospective, large-scale clinical study
Predictive and risk factor analysis for bloodstream infection in high-risk hematological patients with febrile neutropenia: post-hoc analysis from a prospective, large-scale clinical study
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发热性中性粒细胞减少症高危血液病患者血流感染的预测和危险因素分析：来自前瞻性大规模临床研究的事后分析
DOI：
10.1007/s12185-021-03183-x
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发表时间：
2021
影响因子：
2.1
通讯作者：
from the Japan Febrile Neutropenia Study Group
中科院分区：
文献类型：
--
作者：
Okamoto Akinao;Kanda Yoshinobu;Kimura Shun-ichi;Oyake Tatsuo;Tamura Kazuo;from the Japan Febrile Neutropenia Study Group
血液感染（BSI）是中性粒细胞减少性发热（FN）患者常见的并发症。BSI风险因素和发病率因化疗类型和预防性抗菌药物而异。我们澄清了这些问题的前瞻性临床试验队列严重FN在hematologicalmalignancy.MethodsWe进行了一个意向治疗分析413高危患者和1272血培养sets.ResultsOverall，356例（86.2%）开发FN，和20.8%的BSI并发症。预防性抗菌药物不能预防FN和BSI的并发症，但革兰氏阴性（GN）细菌BSI的发生率低于非预防组（23.8% vs. 56.7%）。多国癌症支持治疗协会（MASCC）评分< 20与BSI的发生率显著相关，而MASCC评分> 21则与BSI的发生率无关（41.7% vs. 17.2%）。唯一显著的风险因素是低血压和脱水。GN引起的BSI的腋窝温度高于革兰氏阳性引起的BSI和血培养结果阴性的患者（38.7 °C vs. 38.2 °C vs. 38.0 °C）。结论MASCC评分和腋温是BSI的强预测因子。未使用预防性抗菌药物与GN引起的BSI相关。临床试验注册号UMIN00010411。
ObjectivesBloodstream infection (BSI) is a frequent complication observed in patients with febrile neutropenia (FN). BSI risk factors and incidence vary depending on chemotherapy types and prophylactic antimicrobial agents. We clarified these issues by post-hoc analysis of a prospective clinical trial cohort for severe FN in hematological malignancy.MethodsWe performed an intention-to-treat analysis of 413 high-risk patients and 1272 blood culture sets.ResultsOverall, 356 patients (86.2%) developed FN, and 20.8% had BSI complications. Prophylactic antimicrobials did not prevent complications of FN and BSI, but the incidence of BSIs of Gram-negative (GN) bacteria was lower than in the non-prophylaxis group (23.8% vs. 56.7%). Multinational Association of Supportive Care in Cancer (MASCC) scores < 20 were significantly correlated with the incidence of BSI, whereas MASCC scores > 21 were not (41.7% vs. 17.2%). The only significant risk factors were hypotension and dehydration. axillary temperatures were higher in GN-caused BSIs than in Gram-positive-caused BSIs and in patients with negative blood culture results (38.7 °C vs. 38.2 °C vs. 38.0 °C). The higher the fever, the higher the incidence of BSI and GN bacteremia.ConclusionsMASCC score and axillary temperature are strong predictors of BSI. Non-administration of prophylactic antimicrobials and GN-caused BSI are correlated.The clinical trial registration numberUMIN00010411.
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影响因子：
45.3
作者：
Klastersky, J;Paesmans, M;Talcott, J
通讯作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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影响因子：
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