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Enterococcal septicemia in patients with hematological malignancies
M Venditti1, A Tarasi, U Visco Comandini
1Servizio Aggregato di Consulenze Infettivologiche, Università La Sapienza, Rome, Italy.
Summary
Enterococcal septicemia in patients with hematological malignancies often indicates intestinal damage from cytotoxic drugs, not a primary invasive infection. Mortality is higher with clinically significant cases, but often not directly caused by enterococci.
Area of Science:
- Infectious Diseases
- Hematology
- Oncology
Background:
- Enterococcal septicemia is a concern in immunocompromised patients.
- Hematological malignancies increase susceptibility to infections.
Purpose of the Study:
- To analyze the clinical significance and outcomes of enterococcal septicemia in patients with hematological malignancies.
- To determine the source and prognostic factors of enterococcal septicemia in this patient population.
Main Methods:
- Retrospective review of 36 cases of enterococcal septicemia.
- Categorization of cases based on clinical significance using defined criteria.
- Analysis of patient demographics, treatment, infection source, and outcomes.
Main Results:
- Most patients were male, had acute leukemia, received cytotoxic therapy, and were granulocytopenic.
- Intestinal sources were common (42%), with unknown sources in 50%.
- Mortality was 19% for clinically significant septicemia and 30% for uncertain significance; few deaths were directly attributed to enterococci.
Conclusions:
- Enterococcal septicemia in hematological malignancy patients often signifies cytotoxic drug-induced intestinal damage.
- It may not represent a truly invasive infection unless intravascularly associated.
- Clinical significance and polymicrobial nature influence outcomes.