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

Abstract

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.

Chondroblastoma in a Distal Phalanx of the Great Toe &ndash; A Rare Case Report

“…[5] It has a gritty and chalky cut surface due to calcification. [6] Chondroblastoma presenting on the distal phalanx of the great toe was unusual. Several studies have concluded that CB is derived from epiphyseal cartilage cells or in the adult population it may be due to chondroid formation by multipotential mesenchymal cells of tendon sheath as suggested by Brien et al [7] Other mimics like giant cell tumors, chondromyxoid fibroma, aneurysmal bone cysts, and clear cell chondrosarcoma were differentiated on a histopathological examination.…”

Physiological Features of Erythrocytes in the Aging Organism

“…The level of plasma lipid peroxidation was assessed in the course of determining the active substances contained in plasma using a kit manufactured by Agat-Med (Russia) and by the content of acyl hydroperoxides in plasma (Ashtiani et al, 2021;Ong et al, 2021). In all cases, the level of plasma antioxidant activity was determined (Abdaltif et al, 2021).…”

Drug choice to lowering risk contiguity with Morbus Hansen disease: A review article

“…Accumulation of clofazimine in macrophages likely affects the capacity of macrophages to process and present antigens thereby limiting their movement and activation, IL-2 release, and clonal expansion. In contrast to dapsone, this drug has a role in suppressing the release of cytokines (IL-1) causing decreased movement of lymphocytes to the type 1 reaction site or reversal reaction [19]. Due to the long half-life of this drug (about 2 months) and its tissue storage, it can maintain activity even when given intermittently, although intermittent administration is not as effective as regular daily administration or when given intermittently every 2 days.…”