Analysis of risk factors and clinical indicators in bloodstream infections among patients with hematological malignancy : a retrospective study

Abstract

Background: The incidence of bloodstream infection caused by bacteremia is more common in patients with hematological malignancy. It is important to distinguish infectious episodes from non-infectious episodes. The present study was aimed to describe epidemiology and clinical indexes for in-hospital infection of hematological malignancy patients.Methods: Single-center retrospective research was performed on hematological malignancy patients admitted to our hospital from July 2015 to March 2018. Laboratory and clinical information from 322 febrile patients were acquired. These episodes were divided by blood culture results into two groups: (1) blood culture positive group, (2) blood culture negative group.Results: In the 322 febrile cases, 81 (25.2%) patients were blood culture positive, and among them, Gram-negative bacteria (51.9%) were more isolated than Gram-positive bacteria (32.1%) and fungi (7.4%). Gram-negative bacteria were more likely to have a drug resistance than Gram-positive bacteria. Independent risk factors revealed that patients with complications, high levels of procalcitonin (PCT), glucose, interleukin-6 (IL-6) and d-dimer (D-D), and low concentration of albumin were correlated with occurrence of infection. PCT, IL-6 and D-D performed well in differentiating not only the infection group from the non-infection group, but also in the Gram-negative group from the Gram-positive group with the areas under the curve all above 0.75.Conclusions: We analyzed the risk factors for bloodstream infection in patients with hematological malignancy, the distribution of bacteria, antibiotics resistance and the changes of clinical parameters. This single-center retrospective study may provide clinicians insight to the diagnosis and treatment of infection.