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Background <p>Patients with hematological malignancies (HMs) are at high risk of bloodstream infections (BSIs) during episodes of febrile neutropenia (FN). However, empirical treatment initiated before isolation of the causative agent from blood cultures is crucial. The aim of this study was to determine the distribution and antimicrobial resistance profile of microorganisms isolated from BSIs in patients with HMs, and to evaluate the association with the need for intensive care unit (ICU) and mortality at 30 days.</p> Methods <p>Single-centre data from patients with HMs who were admitted to the hematology inpatient clinic and had a BSI during an episode of FN were retrospectively reviewed.</p> Results <p>A total of 164 FN episodes with BSI in 122 patients were analysed. Of the 164 episodes, 56.7% were Gram-negative. The most prevalent Gram-negative bacterium was <i>Escherichia coli</i> (31%). The positivity rate for extended-spectrum beta-lactamase (ESBL) was 49.3%, and the rate of carbapenem resistance was 20.2%. In multivariate analyses restricted to Gram-negative BSIs, carbapenem resistance was independently associated with both 30-day ICU admission and 30-day all-cause mortality, whereas ESBL positivity was not independently associated.</p> Conclusion <p>The rates of ESBL positivity and carbapenem resistance in Gram-negative bacteria are notable. However, only carbapenem resistance was independently associated with adverse clinical outcomes. Therefore, in line with regional surveillance data, empirical antibiotic strategies should take into account local resistance patterns, particularly carbapenem resistance, in FN episodes.</p>

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Evaluation of bloodstream infections in febrile neutropenic patients with hematological malignancy: a retrospective cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月29日

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  • Muhammet Salih Tarhan,
  • Yusuf Emre Özdemir,
  • Laden Çamber,
  • Fehmi Hindilerden,
  • Emine Gültürk,
  • Habip Gedik,
  • Kadriye Kart Yaşar

摘要

Background

Patients with hematological malignancies (HMs) are at high risk of bloodstream infections (BSIs) during episodes of febrile neutropenia (FN). However, empirical treatment initiated before isolation of the causative agent from blood cultures is crucial. The aim of this study was to determine the distribution and antimicrobial resistance profile of microorganisms isolated from BSIs in patients with HMs, and to evaluate the association with the need for intensive care unit (ICU) and mortality at 30 days.

Methods

Single-centre data from patients with HMs who were admitted to the hematology inpatient clinic and had a BSI during an episode of FN were retrospectively reviewed.

Results

A total of 164 FN episodes with BSI in 122 patients were analysed. Of the 164 episodes, 56.7% were Gram-negative. The most prevalent Gram-negative bacterium was Escherichia coli (31%). The positivity rate for extended-spectrum beta-lactamase (ESBL) was 49.3%, and the rate of carbapenem resistance was 20.2%. In multivariate analyses restricted to Gram-negative BSIs, carbapenem resistance was independently associated with both 30-day ICU admission and 30-day all-cause mortality, whereas ESBL positivity was not independently associated.

Conclusion

The rates of ESBL positivity and carbapenem resistance in Gram-negative bacteria are notable. However, only carbapenem resistance was independently associated with adverse clinical outcomes. Therefore, in line with regional surveillance data, empirical antibiotic strategies should take into account local resistance patterns, particularly carbapenem resistance, in FN episodes.