Oncology patients undergoing cancer treatment and experiencing episodes of fever are known to be at increased risk for invasive bacterial infection, including bloodstream infection. This study aimed to identify the incidence of bacteremia along with the bloodstream isolates for immunocompromised oncology patients referred to the emergency department (ED) due to fever.
Methods
Oncology patients with fever were referred to the ED according to a protocol previously reported. Virtually all children had central venous access devices (CVAD) that underwent sterile access according to Hematology-Oncology (Hem-Onc) and ED protocol. Antibiotics were administered to all patients once CVAD were accessed and laboratory studies, including blood culture, were obtained. Data collected included patient demographic features, complete blood count profiles, proportions receiving antibiotics within 60 minutes of ED arrival and subsequent blood culture results.
Results
Of 1,088 consecutively referred Hem-Onc patients, 439 were eligible for inclusion. The overall blood culture positive rate was 5.7%. Fifty-six percent of patients with positive blood cultures had an absolute neutrophil count greater than 500 µL at the time of ED presentation. Gram-positive organisms comprised 64% of isolates while gram-negative organisms accounted for 36% of the total isolates.
Conclusions
Immunocompromised oncology patients presenting to the ED with fever are susceptible to bloodstream infection caused by an array of gram-positive and gram-negative organisms. Bloodstream infection during episodes of fever includes many patients without severe neutropenia at presentation and with bloodstream isolates not typically associated with catheter-related bloodstream infection alone, highlighting the diversity and variability within this patient population.
Full text
https://www.xiahepublishing.com/2996-3427/OnA-2023-00047
The study was recently published in the Oncology Advances.
Oncology Advances is dedicated to improving the diagnosis and treatment of human malignancies, advancing the understanding of molecular mechanisms underlying oncogenesis, and promoting translation from bench to bedside of oncological sciences. The aim of Oncology Advances is to publish peer-reviewed, high-quality articles in all aspects of translational and clinical studies on human cancers, as well as cutting-edge preclinical and clinical research of novel cancer therapies.
