Archive \ Volume.12 2021 Issue 3

Bloodstream Infections in Solid Tumor Malignancy: Risk Factors and Clinical Outcome

Ann Gie Ong , Endang Kumolosasi , Farida Islahudin , Si Yan Chan , Xin Yi Lim , Suhaila Md Hanapiah , Azmi Nor Mohd Farez Ahmat

Bloodstream infection (BSI) is a common complication in patients with solid tumor malignancies but available information on risk factors associated with BSI among these patients is scarce. To determine the associated risk factors and clinical outcomes of antibiotic treatment in BSI solid tumor malignancies. This was a retrospective case-control study performed in the National Care Centre. Adult patients with solid tumor malignancy and positive for blood culture bacteria growth (n=130) as well as adult patients with solid tumor malignancy and negative for blood culture bacteria growth were included (n=130). The most common form of solid malignancy (n=260) are those associated with digestive organs (n=72, 27.7%) and breast tumors (n=57, 21.9%). From 130 patients that were positive for BSI, gram-negative infection occurred in 71.5% (n=93) of the cases, mainly due to Klebsiella pneumoniae (n=31, 21.5%), Escherichia coli (n=24, 16.7%), and Pseudomonas aeruginosa (n=17, 11.8%). 98.2% (n=128) of BSI patients received empirical antimicrobial therapy while 58.5% (n=76) received adequate empirical antibiotic coverage. Elevated CRP levels (Adjusted OR=1.009; 95%CI=1.003–1.015; p=0.002) and total lymphocyte counts of <0.8x109/L (Adjusted OR=3.980; 95%CI=1.567–10.108; p=0.004) were found to be independent risk factors of BSI in solid tumor malignancy. There was no significant association between adequacy of empirical antibiotic coverage with the length of hospital stay (p=0.149), 48-hours all-cause mortality (p=0.255), and 28-days all-cause mortality (p=0.676). Close monitoring of the CRP elevation and presence of total lymphocyte counts <0.8x109/L may be used to determine the high risk for BSI in solid tumor malignancy patients.

How to cite:
Ong A G, Kumolosasi E, Islahudin F, Chan S Y, Lim X Y, Hanapiah S M, et al. Bloodstream Infections in Solid Tumor Malignancy: Risk Factors and Clinical Outcome. Arch. Pharm. Pract. 2021;12(3):34-40.
Ong, A. G., Kumolosasi, E., Islahudin, F., Chan, S. Y., Lim, X. Y., Hanapiah, S. M., & et al (2021). Bloodstream Infections in Solid Tumor Malignancy: Risk Factors and Clinical Outcome. Archives Of Pharmacy Practice, 12(3),34-40.

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