Infection-related hospitalizations in breast cancer patients: Risk and impact on prognosis

Brand, Judith S.; Colzani, Edoardo; Johansson, Anna L.V.; Giesecke, Johan; Clements, Mark; Bergh, Jonas; Hall, Per; Czene, Kamila

doi:10.1016/j.jinf.2016.04.003

Cited by 28 publications

(37 citation statements)

References 33 publications

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“…An interesting finding of our study is that the presence of respiratory tract infection is an independent risk factor for 30-day mortality in these patients as well despite its small proportion in our cohort. This may have been due to respiratory tract infection is a strong independent predictor of chemotherapy interruption, which in turn impacts disease control [23]. Our analysis demonstrated that septic shock is also an independent risk factor for 30-day mortality in patients with ESBL-PE caused nosocomial infections, which is also similar to previous studies [14][15][16].…”

Section: Discussionsupporting

confidence: 88%

Clinical characteristics, antibiotic-resistant patterns and prognostic factors in cancer patients with nosocomial infections caused by extended-spectrum beta-lactamase-producing Escherichia coli: a retrospective study from 2013 to 2019

Jiang¹,

Shi²,

Liu³

et al. 2019

Preprint

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Background: Nosocomial infections due to Extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) is increasing worldwide. This study aimed to describe the clinical characteristics, antibiotic-resistant patterns, and prognostic factors associated with nosocomial infections caused by ESBL-PE in cancer patients. Methods: This retrospectively analyzed patients with nosocomial infections caused by E. coli from August 2013 to May 2019 and was conducted to investigate the risk factors, clinical features, outcomes, and antibiotic-resistant patterns of these infections. Results: Of the 1008 nosocomial infection episodes, 265 patients suffered from infections with E. coli, and 155 episodes were caused by ESBL-PE. A multivariate analysis showed that the length of antibiotics treatment more than 6.93 days was an independent risk factor for nosocomial infections in cancer patients caused by ESBL-PE. ECOG performance status score more than 2, presence of respiratory tract infection, septic shock, lymphocytopenia, and hypoproteinemia were independent risk factors for 30-day mortality in cancer patients caused by ESBL-PE. Antimicrobial susceptibility showed that the isolated ESBL-PE were highly resistant to aztreonam and third-generation cephalosporins. Conclusions: The length of antibiotics treatment more than 6.93 days increased the risk ratio for ESBL-PE caused nosocomial infections. However, there was no significant difference in the prognoses of patients with ESBL-PE and non-ESBL-PE caused nosocomial infections. ECOG performance status score more than 2, presence of respiratory tract infection, septic shock, lymphocytopenia, and hypoproteinemia were independent risk factors for 30-day mortality in cancer patients with nosocomial infections caused by E. coli. The isolated ESBL-PE were highly resistant to aztreonam and third-generation cephalosporins.

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Section: Discussionsupporting

confidence: 88%

Clinical characteristics, antibiotic-resistant patterns and prognostic factors in cancer patients with nosocomial infections caused by extended-spectrum beta-lactamase-producing Escherichia coli: a retrospective study from 2013 to 2019

Jiang¹,

Shi²,

Liu³

et al. 2019

Preprint

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“…It has been demonstrated that infection‐related hospitalizations are independent predictors of overall and BC‐specific survival . Neutropenia is a common complication of chemotherapy and can lead to the development of sepsis.…”

Section: Discussionmentioning

confidence: 99%

“…It has been demonstrated that infection-related hospitalizations are independent predictors of overall and BC-specific survival. 32 Neutropenia is a common complication of chemotherapy and can lead to the development of sepsis. In our study, we found a significant high risk of death from septicemia and other infectious and parasitic diseases particularly within the first year after cancer diagnosis, probably because of systemic chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Causes of death after breast cancer diagnosis: A US population‐based analysis

Afifi

Saad

Al‐Husseini

et al. 2019

Cancer

134

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Background The focus on noncancer causes of death in patients with breast cancer (BC) remains superficial. The objective of the current study was to assess and quantify causes of death after BC diagnosis. Methods In total, 754,270 women with BC in the United States who were diagnosed during 2000 through 2015 and retrieved from the Surveillance, Epidemiology, and End Results (SEER) program were studied. Standardized mortality ratios (SMRs) for causes of death were calculated. Results Of the included patients, 183,002 (24.3%) died during the follow‐up period. The greatest proportion of deaths (46.2%) occurred within 1 to 5 years after diagnosis. Most deaths occurred from BC itself or from other cancers, and the number of BC deaths decreased as more years passed after diagnosis. The most common noncancer causes of death within <10 years after diagnosis were heart diseases followed by cerebrovascular diseases. However, >10 years after diagnosis, the most common noncancer causes of death were heart diseases followed by Alzheimer disease. Patients had a statistically significant higher risk of death from chronic liver diseases within 5 to 10 years after diagnosis compared with the general population (SMR, 1.23; 95% CI, 1.09‐1.38) and had statistically significant higher risks of death from Alzheimer disease (SMR, 1.21; 95% CI, 1.14‐1.29) and from diseases of the heart (SMR, 1.06; 95% CI, 1.02‐1.09) >10 years after diagnosis. Conclusions Although BC remains the most common cause of death after BC diagnosis, other non‐BC causes of death (mainly heart and cerebrovascular diseases) represent a significant number of deaths among patients with BC. These findings provide important insight into how BC survivors should be counselled regarding future health risks.

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“…Bacterial infections are the most frequent complications in patients with malignancy as these patients are more likely to be immunocompromised due to malnutrition, invasive procedures, surgery, chemotherapy, radiation, and some new treatment modalities [1,2]. There is growing evidence suggested that infection in cancer patients is associated delayed initiation of chemotherapy, reduced standard dosage, prolonged hospitalization, increased financial burden of healthcare, and raised severe morbidity and mortality [3][4][5][6]. The epidemiology of nosocomial infections among cancer patients has changed over time, and the causative organisms of nosocomial infections had shifted from Gram-positive pathogens to Gram-negative pathogens in the last 20 years worldwide [7].…”

Section: Introductionmentioning

confidence: 99%

Nosocomial Infections Due to Multidrug-Resistant Bacteria in Cancer Patients: A Seven-Year Experience of an Oncology Center in Western China

Jiang

Shi

Liu

et al. 2020

Preprint

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Abstract Background: Bacterial infections are the most frequent complications in patients with malignancy, and the epidemiology of nosocomial infections among cancer patients has changed over time. This study aimed to evaluate characteristics, antibiotic-resistant patterns, and prognosis of nosocomial infections caused by multidrug-resistant bacteria (MDR) in cancer patients. Methods: This retrospectively analyzed cancer patients with MDR bacteria caused nosocomial infections from August 2013 to May 2019 and was conducted to explore the risk factors, clinical features, outcomes, and antibiotic-resistant patterns of these infections. Results: Overall, 257 cancer patients developed nosocomial infections caused by MDR bacteria. Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae was the most frequently isolated multidrug-resistant Gram-negative bacteria (MDRGNB), followed by ESBL-producing Klebsiella pneumonia, and Acinetobacter baumannii. Cancer patients with liver disease, received intrapleural/abdominal infusion within 30 days, length of hospitalization, hemoglobin, and albumin were independent factors for 30-day mortality in the study population. The isolated MDR bacteria were highly sensitive to amikacin, meropenem, imipenem, tigecycline, and piperacillin/tazobactam. Conclusions: Cancer patients with prolonged hospitalization was an independent predictor of a favorable outcome. However, cancer patients with liver disease, received intrapleural/abdominal infusion within 30 days, anemia, and hypoproteinemia were independent risk factors of 30-day mortality.

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Infection-related hospitalizations in breast cancer patients: Risk and impact on prognosis

Abstract: A significant number of breast cancer patients are hospitalized with an infection following diagnosis, which in turn predicts poor prognosis. The risk profile of infection-related hospitalizations is multifactorial, including patient, tumor and treatment-related factors.

Cited by 28 publications

References 33 publications

Clinical characteristics, antibiotic-resistant patterns and prognostic factors in cancer patients with nosocomial infections caused by extended-spectrum beta-lactamase-producing Escherichia coli: a retrospective study from 2013 to 2019

Clinical characteristics, antibiotic-resistant patterns and prognostic factors in cancer patients with nosocomial infections caused by extended-spectrum beta-lactamase-producing Escherichia coli: a retrospective study from 2013 to 2019

Causes of death after breast cancer diagnosis: A US population‐based analysis

Nosocomial Infections Due to Multidrug-Resistant Bacteria in Cancer Patients: A Seven-Year Experience of an Oncology Center in Western China

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