Evaluation of Enterobacterales bloodstream infections in hematologic cancer patients

Authors : Esra Tavukcu, Ferzan Arslan, Serap Suzuk, Ayşe Güreser, İpek Mumcuoğlu, Nese Inan, Turgay Ulaş, Tuba Dal

Pages : 207-217

Doi:10.31362/patd.1513010

View : 100 | Download : 184

Publication Date : 2025-01-01

Article Type : Research Paper

Abstract :Purpose: In this study, we aimed to evaluate the clinical and laboratory findings of hospitalized patients with Enterobacterales bacteremia/sepsis, the risk factors for mortality and the therapeutic options for treating bloodstream infections (BSIs) caused by Enterobacterales. Materials and methods: Patients hospitalized in the Oncology Hospital between January 2021 and December 2022 whose Enterobacterales species were isolated in blood cultures were included in the study. Blood cultures were incubated in the Autobio BC120 device. Isolated microorganisms were named using a Vitek-2 (bioMerieux, France) automated system. Antibiotic susceptibility tests were performed in the Vitek-2 system (bioMerieux, France) and the disc diffusion method. In addition, the demographic and laboratory data of the patients were evaluated. A total of 103 patients were included in the study during the two years. Only the first isolates from each patient were included in the study. Results: The distribution of Enterobacterales isolates grown in blood cultures, in order of frequency were Escherichia coli (n:74, 63.25%), Klebsiella pneumoniae ssp pneumoniae (n:27, 23.1%), Klebsiella pneumoniae ssp ozaenae (n:2, 1.71%), Klebsiella oxytoca (n:1, 0.85%), Enterobacter cloaceae complex (n:10, 6.84%), Citrobacter freundii (n:1), Proteus mirabilis (n:1), Salmonella spp (n:1). The median (min-max) white blood cell count was 1.51x103cells/uL (0.01-19.87), C-reactive protein (CRP) was 112.3 mg/L (0.06-546.0), procalcitonin was 7.35 μg/L (0.05-61.21), time between blood culture collection and growing signal was 11.33 (3-58) hours and the blood culture result report was three (1-8) days. Acute Myeloid Leukemia 40 (39.2%), B-cell Acute Lymphoblastic leukemia 18 (17.6%), Multiple Myeloma 11 (10.8%), Diffuse Large B-cell Lymphoma 11 (10.8%) were the most common diseases seen in Enterobacterales isolated patients from blood cultures. Conclusion: Each hospital should conduct its evaluation and examine the patient profile to make the correct empirical antibiotic selection. It is crucial to develop a suitable algorithm for this purpose.
Keywords : Enterobacterales, kan dolaşımı enfeksiyonları, hematolojik kanser hastaları