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Gram-negative septicemia in patients with hematologic malignancies
European Journal of Cancer & Clinical Oncology
|March 1, 1984
Summary
Gram-negative bacteremia in hematologic malignancy patients has a high mortality rate. Key poor prognostic factors include Pseudomonas infection, persistent neutropenia, pneumonia, septic shock, and incorrect antibiotic treatment.
Area of Science:
- Infectious Diseases
- Hematology
- Critical Care Medicine
Background:
- Gram-negative bacteremia poses a significant threat to patients with hematologic malignancies.
- Neutropenia is a common complication in these patients, increasing susceptibility to infections.
Purpose of the Study:
- To identify major prognostic factors influencing mortality in Gram-negative bacteremia among patients with hematologic malignancies.
- To analyze the impact of specific pathogens, neutropenia, and treatment on outcomes.
Main Methods:
- Retrospective review of clinical records from 66 episodes of Gram-negative bacteremia in 60 patients with hematologic malignancies.
- Analysis of mortality rates in relation to causative organisms, neutrophil counts, presence of pneumonia, septic shock, and antibiotic therapy.
Main Results:
- Overall bacteremia-related mortality was 53%.
- Pseudomonas aeruginosa and Escherichia coli were the predominant pathogens, with high fatality rates (78% and 31%, respectively).
- Persistent neutropenia (PMN < 1000/microliters), pneumonia-associated bacteremia, septic shock, and inappropriate antibiotic therapy were associated with significantly higher mortality.
Conclusions:
- Pseudomonas etiology, persistent neutropenia, associated pneumonia, septic shock, and inappropriate antibiotic therapy are critical indicators of a poor prognosis in Gram-negative bacteremia within this patient population.
- Early identification and management of these factors are crucial for improving patient outcomes.