Predictive factors of septic shock and mortality in neutropenic patients
Neutropenia is a major risk factor for developing a serious infection. Bacteremia still causes significant mortality among neutropenic patients with cancer. The purpose of this study was to identify risk factors for septic shock and for mortality in neutropenic patients with leukemia and bacteremia....
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Published in | Hematology (Luxembourg) Vol. 12; no. 6; pp. 543 - 548 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
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England
Taylor & Francis
01.12.2007
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Abstract | Neutropenia is a major risk factor for developing a serious infection. Bacteremia still causes significant mortality among neutropenic patients with cancer. The purpose of this study was to identify risk factors for septic shock and for mortality in neutropenic patients with leukemia and bacteremia. Consecutive samples from 20 patients with acute myeloid leukemia and bacteremia were studied during a 1 year period (January-December 2003). All patients received empirical antibiotic therapies for febrile episodes using ceftazidime plus amikacin. About 110 neutropenic febrile episodes were noted: clinically documented 14.54%, microbiologically documented 16.36% and fever of unknown origin 69.09%. Gram-negative organism caused eight febrile episodes: Pseudomonas (5), Klebsiella (3). Gram-positive organism caused 10 episodes: Staphylococcus (6), Streptococci (2), Enterococci (2). Pulmonary infection accounted for 25% of clinically documented infections. About 14 of the 110 febrile episodes were associated with septic shock causing mortality in 7 patients. In a univariate analysis variables associated with septic shock were: pulmonary infection (OR = 17, p = 0.001), serum bicarbonate < 17 mmol/l (OR = 68, p < 0.001) and serum lactate >3 mmol/l (OR = 62, p < 0.001). Variables associated with mortality were: pulmonary infection (OR = 83, p < 0.001) and serum bicarbonate < 17 mmol/l (OR = 61, p < 0.001).
In a multivariate analysis two variables were associated with septic shock: pulmonary infection (OR = 5, p = 0.043) and serum lactate >3 mmol/l (OR = 10, p = 0.003). An elevated serum lactate (>3 mmol/l) and low serum bicarbonate (< 17 mmol/l) at the onset of bacteremia are useful biomarkers in predicting septic shock and mortality in neutropenic patients. |
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AbstractList | Neutropenia is a major risk factor for developing a serious infection. Bacteremia still causes significant mortality among neutropenic patients with cancer. The purpose of this study was to identify risk factors for septic shock and for mortality in neutropenic patients with leukemia and bacteremia. Consecutive samples from 20 patients with acute myeloid leukemia and bacteremia were studied during a 1 year period (January-December 2003). All patients received empirical antibiotic therapies for febrile episodes using ceftazidime plus amikacin. About 110 neutropenic febrile episodes were noted: clinically documented 14.54%, microbiologically documented 16.36% and fever of unknown origin 69.09%. Gram-negative organism caused eight febrile episodes: Pseudomonas (5), Klebsiella (3). Gram-positive organism caused 10 episodes: Staphylococcus (6), Streptococci (2), Enterococci (2). Pulmonary infection accounted for 25% of clinically documented infections. About 14 of the 110 febrile episodes were associated with septic shock causing mortality in 7 patients. In a univariate analysis variables associated with septic shock were: pulmonary infection (OR = 17, p = 0.001), serum bicarbonate < 17 mmol/l (OR = 68, p < 0.001) and serum lactate >3 mmol/l (OR = 62, p < 0.001). Variables associated with mortality were: pulmonary infection (OR = 83, p < 0.001) and serum bicarbonate < 17 mmol/l (OR = 61, p < 0.001).
In a multivariate analysis two variables were associated with septic shock: pulmonary infection (OR = 5, p = 0.043) and serum lactate >3 mmol/l (OR = 10, p = 0.003). An elevated serum lactate (>3 mmol/l) and low serum bicarbonate (< 17 mmol/l) at the onset of bacteremia are useful biomarkers in predicting septic shock and mortality in neutropenic patients. Neutropenia is a major risk factor for developing a serious infection. Bacteremia still causes significant mortality among neutropenic patients with cancer. The purpose of this study was to identify risk factors for septic shock and for mortality in neutropenic patients with leukemia and bacteremia. Consecutive samples from 20 patients with acute myeloid leukemia and bacteremia were studied during a 1 year period (January-December 2003). All patients received empirical antibiotic therapies for febrile episodes using ceftazidime plus amikacin. About 110 neutropenic febrile episodes were noted: clinically documented 14.54%, microbiologically documented 16.36% and fever of unknown origin 69.09%. Gram-negative organism caused eight febrile episodes: Pseudomonas (5), Klebsiella (3). Gram-positive organism caused 10 episodes: Staphylococcus (6), Streptococci (2), Enterococci (2). Pulmonary infection accounted for 25% of clinically documented infections. About 14 of the 110 febrile episodes were associated with septic shock causing mortality in 7 patients. In a univariate analysis variables associated with septic shock were: pulmonary infection (OR = 17, p = 0.001), serum bicarbonate < 17 mmol/l (OR = 68, p < 0.001) and serum lactate >3 mmol/l (OR = 62, p < 0.001). Variables associated with mortality were: pulmonary infection (OR = 83, p < 0.001) and serum bicarbonate < 17 mmol/l (OR = 61, p < 0.001). In a multivariate analysis two variables were associated with septic shock: pulmonary infection (OR = 5, p = 0.043) and serum lactate >3 mmol/l (OR = 10, p = 0.003). An elevated serum lactate (>3 mmol/l) and low serum bicarbonate ( < 17 mmol/l) at the onset of bacteremia are useful biomarkers in predicting septic shock and mortality in neutropenic patients. |
Author | Mohamed, Zarrouk Yosr, Benabdennebi Hela, Ben Abid Ramzi, Jeddi Balkis, Meddeb Karima, Kacem Lamia, Aissaoui Raihane, Benlakhal Zaher, Belhadjali |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/17852435$$D View this record in MEDLINE/PubMed |
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Cites_doi | 10.1007/s00277-006-0096-2 10.1007/BF03014326 10.1097/00003246-199806000-00019 10.1086/339215 10.1093/jac/41.suppl_4.13 10.1046/j.1365-2141.2001.03083.x 10.1097/00003246-200107000-00002 10.1001/archinte.160.4.501 10.1007/s001340050015 10.1007/s100960000410 10.1177/0885066605278644 10.1097/00003246-200001000-00019 10.1007/s100960050345 10.1007/BF01712155 10.1503/cmaj.050632 10.1681/ASN.V123515 10.1097/00003246-198908000-00001 10.1007/BF01700277 10.1097/01.CCM.0000157787.24595.5B 10.1086/374339 10.1086/514550 10.1056/NEJMoa022139 10.1097/00043426-199805000-00006 10.1016/S0140-6736(97)09214-3 10.1097/01.CCM.0000050454.01978.3B 10.1097/00003246-199206000-00025 10.1056/NEJMoa010307 |
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SubjectTerms | Adult Bacteremia Bacteria - isolation & purification Bicarbonates - blood CHEMOTHERAPY Female Fever Humans Lactic Acid - blood Leukemia, Myeloid, Acute - complications Leukemia, Myeloid, Acute - drug therapy Leukemia, Myeloid, Acute - mortality Male Middle Aged NEUTROPENIA Neutropenia - chemically induced Neutropenia - diagnosis Neutropenia - mortality Pneumonia, Bacterial PREDICTIVE FACTORS Prognosis Risk Factors SEPSIS Shock, Septic - diagnosis Shock, Septic - mortality |
Title | Predictive factors of septic shock and mortality in neutropenic patients |
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