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Etiology, clinical course and outcome of healthcare-associated bloodstream infections in patients with haematological malignancies: a retrospective study of 350 patients in a Finnish tertiary care hospital Emilia Åttman, Janne Aittoniemi, Marjatta Sinisalo, Risto Vuento, Outi Lyytikäinen, Tommi Kärki, Jaana Syrjänen and Reetta Huttunen Leuk Lymphoma Downloaded from informahealthcare.com by Kainan University on 04/10/15 For personal use only.
DOI: 10.3109/10428194.2015.1032967 Abstract This retrospectively collected laboratory-based surveillance data includes 575 healthcare-associated BSIs in 350 patients with haematological malignancy in Tampere University Hospital, Finland, during 1999-2001 and 2005-2010. The most common underlying diseases were acute myelogenous leukemia (n=283, 49%), followed by myeloma (n=87, 15%) and acute lymphocytic leukemia (n=76, 13%). The overall rate was 9.1 BSIs per 1000 patient-days. Grampositive BSIs predominated and the most common pathogens were coagulase-negative staphylococci (23%), viridans streptococci (11%), enterococci (9%) and Escherichia coli (9%). Fungi caused 2% of BSIs. 7-day and 28-day case fatalities were 5% and 10% and were highest in BSIs caused by Pseudomonas aeruginosa (19% and 34%, respectively). The median age of patients with BSI has increased; it was 55.0 years during 1999-2001, compared to 59.0 years in 2005-2007 and 59.0 years in 2008-2010 (p1 organism detected in a 48-h period. Infection control nurse reviewed the laboratory database for positive blood Leuk Lymphoma Downloaded from informahealthcare.com by Kainan University on 04/10/15 For personal use only.
culture results in 1999-2001 and 2005-2010. The BACTEC 9240 (BD Diagnostic Systems, Sparks, MD, USA) blood culture system was used until 2007, and from 2007 BacT/ALERT 3D (bioMerieux SA, Mercy L'Etoile, France). Patient-days (year 1999 to 2001 and 2005-2010) and diagnoses of the patients were obtained from the hospital administration of TAUH. Data about the allogeneic HCT were obtained from the register of the HD in Helsinki, Uusimaa and data about autologous HCTs from the European group for blood and marrow transplantation database. The outcome at 7 and 28 days following the date of the first positive blood culture result for a particular patient was obtained from the national population registry by use of unique person identifiers. The day 7 and 28 mortalities represent crude mortality. A bacteremia episode in one patient was considered as a new episode, if the time interval between the two positive blood culture dates were more than one week and the patient had no positive blood cultures less than 7 days between these dates. Statistics An SPSS package (version 20) was used for statistical analyses and a twosided p-value
Etiology, clinical course and outcome of healthcare-associated bloodstream infections in patients with haematological malignancies: a retrospective study of 350 patients in a Finnish tertiary care hospital Emilia Åttman, Janne Aittoniemi, Marjatta Sinisalo, Risto Vuento, Outi Lyytikäinen, Tommi Kärki, Jaana Syrjänen and Reetta Huttunen Leuk Lymphoma Downloaded from informahealthcare.com by Kainan University on 04/10/15 For personal use only.
DOI: 10.3109/10428194.2015.1032967 Abstract This retrospectively collected laboratory-based surveillance data includes 575 healthcare-associated BSIs in 350 patients with haematological malignancy in Tampere University Hospital, Finland, during 1999-2001 and 2005-2010. The most common underlying diseases were acute myelogenous leukemia (n=283, 49%), followed by myeloma (n=87, 15%) and acute lymphocytic leukemia (n=76, 13%). The overall rate was 9.1 BSIs per 1000 patient-days. Grampositive BSIs predominated and the most common pathogens were coagulase-negative staphylococci (23%), viridans streptococci (11%), enterococci (9%) and Escherichia coli (9%). Fungi caused 2% of BSIs. 7-day and 28-day case fatalities were 5% and 10% and were highest in BSIs caused by Pseudomonas aeruginosa (19% and 34%, respectively). The median age of patients with BSI has increased; it was 55.0 years during 1999-2001, compared to 59.0 years in 2005-2007 and 59.0 years in 2008-2010 (p1 organism detected in a 48-h period. Infection control nurse reviewed the laboratory database for positive blood Leuk Lymphoma Downloaded from informahealthcare.com by Kainan University on 04/10/15 For personal use only.
culture results in 1999-2001 and 2005-2010. The BACTEC 9240 (BD Diagnostic Systems, Sparks, MD, USA) blood culture system was used until 2007, and from 2007 BacT/ALERT 3D (bioMerieux SA, Mercy L'Etoile, France). Patient-days (year 1999 to 2001 and 2005-2010) and diagnoses of the patients were obtained from the hospital administration of TAUH. Data about the allogeneic HCT were obtained from the register of the HD in Helsinki, Uusimaa and data about autologous HCTs from the European group for blood and marrow transplantation database. The outcome at 7 and 28 days following the date of the first positive blood culture result for a particular patient was obtained from the national population registry by use of unique person identifiers. The day 7 and 28 mortalities represent crude mortality. A bacteremia episode in one patient was considered as a new episode, if the time interval between the two positive blood culture dates were more than one week and the patient had no positive blood cultures less than 7 days between these dates. Statistics An SPSS package (version 20) was used for statistical analyses and a twosided p-value
