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Risk factors and characteristics of bacterial infection during first-line chemotherapy for metastatic gastric or gastroesophageal junction adenocarcinoma

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Abstract

Purpose

Chemotherapy-related bacterial infection is a common side effect in patients receiving chemotherapy. The purpose of this study was to determine the risk factors and characteristics of bacterial infection in metastatic gastric or gastroesophageal junction (GEJ) adenocarcinoma patients treated with combined chemotherapy.

Methods

Patients with metastatic gastric or GEJ adenocarcinoma were followed up from 2013 to 2016 at Peking University First Hospital in China. Patients were treated with multiple cycles of combined chemotherapy. The incidence rate of bacterial infection and patients’ clinical data were manually reviewed.

Results

A total of 154 patients were eligible and were enrolled in this study. A median of 6 chemotherapy cycles were administered (range, 1–14 cycles). Chemotherapy-related bacterial infections were observed in 36 of 154 patients (23.4%). Pulmonary is the most common site of infections. Ninety-four percent of patients with bacterial infection during chemotherapy received broad-spectrum antibiotics. The independent risk factors for chemotherapy-related bacterial infection identified by multivariable analysis were Nutritional Risk Screening 2002 (NRS2002) ≥ 3 (P = 0.008), ≥ grade 3 neutropenia (P = 0.028), and Eastern Cooperative Oncology Group Performance Status (ECOG PS) ≥ 2 (P = 0.042).

Conclusions

Nearly a quarter of patients with metastatic gastric or GEJ adenocarcinoma who received combined chemotherapy had bacterial infection in this study. The proportion of broad-spectrum antibiotics used in patients with infection is very high. Improving nutritional status may help reduce the incidence of bacterial infection.

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Data availability

Not applicable.

Code availability

SPSS 22.0 statistical software (IBM SPSS Statistics, Armonk, NY, USA).

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Acknowledgements

We are grateful to Lijian Yu from the Dana-Farber Cancer Institute for helpful discussions, and we also thank the patients and their families for supporting the study.

Funding

This is an investigator-driven study with no extemal funding or support.

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Authors and Affiliations

  1. Department of Medical Oncology, Peking University First Hospital, Beijing, 100034, China

    Xuan Jin, Shikai Wu & Yu Bai

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  1. Xuan Jin
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  2. Shikai Wu
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  3. Yu Bai
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Contributions

All authors contributed to the study conception and design. X.J. performed the research. X.J. and Y.B. collected data. X.J., Y.B., and SK.W. analyzed data. X.J. and SK.W. wrote the first draft of the manuscript. Y.B. and SK.W. critically revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Shikai Wu.

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Jin, X., Wu, S. & Bai, Y. Risk factors and characteristics of bacterial infection during first-line chemotherapy for metastatic gastric or gastroesophageal junction adenocarcinoma. Support Care Cancer 30, 2121–2129 (2022). https://doi.org/10.1007/s00520-021-06557-3

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