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Bloodstream infection caused by S. aureus in patients with cancer: a 10-year longitudinal single-center study

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Abstract

Background

Staphylococcus aureus bloodstream infections (SABIs) represent a significant cause of morbidity and mortality in cancer patients. In this study, we compared infection characteristics and evaluated epidemiology and risk factors associated to SABIs and 30-day attributable mortality in cancer patients.

Methods

Clinical and microbiological data from patients with cancer and positive blood cultures for S. aureus were retrieved during a 10-year period at an oncology reference center. Analyses were performed according to type of malignancy and infection with methicillin-resistant S. aureus (MRSA). Data was evaluated using competing risk analyses to identify risk factors associated to 30-day mortality and used to create a point system for mortality risk stratification.

Results

We included 450 patients and MRSA was documented in 21.1%. Hospital-acquired infection, healthcare-associated pneumonia, and type-2 diabetes were associated to MRSA. In patients with hematologic malignancies, MRSA was more frequent if hospital-acquired, but less likely in primary bacteremia. Variables associated to mortality included abdominal source of infection, hematologic malignancy, MRSA, glucose levels > 140 mg/dL, and infectious endocarditis; catheter removal and initiation of adequate treatment within 48 h of positive blood culture were protective factors. From our designed mortality prediction scale, patients with a score > 3 had a 70.23% (95%CI 47.2–85.3%) probability of infection-related death at 30 days.

Conclusion

SABIs are a significant health burden for cancer patients. Risk factors for SABI-related mortality in this population are varied and impose a challenge for management to improve patient’s outcomes. Risk stratification might be useful to evaluate 30-day mortality risk.

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Author notes

  1. Omar Yaxmehen Bello-Chavolla and Jessica Paola Bahena-Lopez contributed equally to this work.

Authors and Affiliations

  1. PECEM, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico

    Omar Yaxmehen Bello-Chavolla & Jessica Paola Bahena-Lopez

  2. Department of Infectious Diseases, Instituto Nacional de Cancerología, San Fernando 22, Sección XVI; Tlalpan, CP 14080,, Mexico City, Mexico

    Omar Yaxmehen Bello-Chavolla, Jessica Paola Bahena-Lopez, Pamela Garciadiego-Fosass, Patricia Volkow, Alejandro Garcia-Horton & Diana Vilar-Compte

  3. Department of Adult Intensive Care Unit, Instituto Nacional de Perinatologia, Mexico City, Mexico

    Pamela Garciadiego-Fosass

  4. Department of Medicine, Division of Hematology, University of Western Ontario, London, ON, Canada

    Alejandro Garcia-Horton

  5. Microbiology Laboratory, Instituto Nacional de Cancerología, Mexico City, Mexico

    Consuelo Velazquez-Acosta

Authors
  1. Omar Yaxmehen Bello-Chavolla
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  2. Jessica Paola Bahena-Lopez
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  3. Pamela Garciadiego-Fosass
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  5. Alejandro Garcia-Horton
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  7. Diana Vilar-Compte
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Contributions

Omar Yaxmehen Bello-Chavolla: Research idea and study design, data acquisition, data analysis/interpretation, statistical analysis, manuscript drafting. Jessica Paola Bahena-López: Research idea and study design, data acquisition, data analysis/interpretation, statistical analysis, manuscript drafting. Pamela Garciadiego-Fosass: Research idea and study design, data acquisition, data analysis/interpretation. Patricia Volkow: Manuscript drafting and mentorship. Alejandro Garcia-Horton: Data acquisition, data analysis/interpretation. Consuelo Velazquez-Acosta: Data acquisition, microbiology analysis and review. Diana Vilar-Compte: Research idea and study design, data acquisition, data analysis/interpretation, manuscript drafting, supervision or mentorship.

Corresponding author

Correspondence to Diana Vilar-Compte.

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The authors declare that they have no conflict of interest.

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For this type of study, formal consent is not required. All data was protected and confidentiality was guaranteed. This article does not contain any studies with human participants or animals performed by any of the authors.

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Bello-Chavolla, O.Y., Bahena-Lopez, J.P., Garciadiego-Fosass, P. et al. Bloodstream infection caused by S. aureus in patients with cancer: a 10-year longitudinal single-center study. Support Care Cancer 26, 4057–4065 (2018). https://doi.org/10.1007/s00520-018-4275-1

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  • DOI: https://doi.org/10.1007/s00520-018-4275-1

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