Aetiology and clinical outcome of blood-stream infections in patients with haematological malignancies in two Danish university hospitals 20002003
Abstract number: 1134_03_369
Møller J.K., Gahrn-Hansen B., Bruun B.G.
To compare etiologies of blood-stream infections according to haematological diagnosis and clinical outcomes of dominating microbiological species/groups at two Danish haematological departments.
A total of 995 blood-stream infections detected in 622 patients between 2000 and 2003 in the two departments were included. Blood-stream infections caused by coagulase-negative staphylococci, coryneforms and propionibacteria were excluded. Bactec® (OUH) or BacT/ALERT® (AUH) blood culture systems were used for blood culturing. Subcultivation and identification was done using standard microbiological laboratory methods. Haematological diagnoses and clinical outcomes were recorded retrospectively by electronic data analysis.
Distributions of haematological diagnoses at the two departments were approximately the same, except for myelomatosis that comprised 19% in AUH and 11% in OUH. We detected a total of 652 and 412 isolates in 609 and 386 blood-stream infections in 360 and 262 patients at AUH and OUH, respectively. A similar proportion of episodes in both hospitals (6%) were polymicrobial. The following differences between microbiological etiology were found: S. pneumoniae, non-haemolytic streptococci, and Gram-negative enterics occurred more frequently at AUH, while enterococci and Gram-negative non-enterics occurred more frequently at OUH. Bacteremia with S. pneumoniae was found in < 1% of AML patients and in about 25% of myelomatosis patients, while E. coli + K. pneumoniaebacteraemia occurred in about 60% of AML patients and 20% of myelomatosis patients. The mortality rate was highest in P. aeruginosa and fungal infections.
It is important to perform local surveillance of blood culture etiology and clinical outcomes of blood stream infections, as these vary between haematological departments. Differences in mortality for specific microorganisms necessitate continuing considerations regarding optimal antimicrobial and adjuvant therapy.
|Session name:||XXIst ISTH Congress|
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