Association of proton pump inhibitors with the occurrence of gut-derived bacteraemia in patients with haematological malignancy after chemotherapy

Figures & data

Table 1 Characteristics of patients with and without gut-derived bacteraemia

Characteristic	Group 1 (bacteraemia) (n = 92)	Group 2 (non-bacteraemia) (n = 92)	P
Demographics
Age, years*	43.2 ± 15.6	43.5 ± 15.0	0.878
Male, n (%)	45 (48.9)	48 (52.1)	0.768
Underlying malignancy
ALL, n (%)	20 (21.7)	18 (19.6)	0.856
AML, n (%)	55 (59.8)	57 (62.0)	0.880
NHL, n (%)	11 (12.0)	11 (12.0)	1.00
MDS, n (%)	4 (4.3)	4 (4.3)	1.00
MM, n (%)	2 (2.2)	2 (2.2)	1.00
Status of malignancy CR, n (%)	42 (45.7)	42 (45.7)	1.00
Length of neutropenia, days*	7.8 ± 3.9	7.6 ± 6.6	0.807
Diabetes mellitus, n (%)	4 (4.3)	4 (4.3)	1.00
Hepatitis B, n (%)	10 (10.9)	7 (7.61)	0.612

*Data are expressed as medians (95% CIs).

ALL, acute lymphoblastic leukaemia; AML, acute myeloid leukaemia; NHL, non-Hodgkin's lymphoma; MDS, myelodysplastic syndrome; MM, multiple myeloma; CR, complete remission.

Table 2 Pathogens and mortality rates

Causative pathogen	Rate (n = 92) (%)	Mortality rate (n = 92) (%)
Gram-negative	76 (82.6)
E. coli	35 (38.0)	3 (3.3)
K. pneumoniae	24 (26.1)	1 (1.1)
E. cloacae	7 (7.6)
Pseudomonas aeruginosa	5 (5.4)
Proteus mirabilis	2 (2.2)
Enterobacter agglomerans	1 (1.1)
Enterobacter aerogenes	1 (1.1)
Chryseobacterium indologenes	1 (1.1)
Gram-positive	9 (9.8)
S. viridans	5 (5.4)
Leuconostoc pseudomesenteroides	4 (4.3)
Polymicrobial bacteraemia	7 (7.6)	2 (2.2)

Table 3 Details of PPI use

	Group 1 (bacteraemia) (n = 64)	Group 2 (non-bacteraemia) (n = 44)	P
i.v. administration (%)	23 (35.9)	19 (43.2)	0.430
q.d. PPI dosage (%)	51 (79.7)	33 (75)	0.817
Appropriate PPI therapy (%)	29 (45.3)	22 (50)	0.696

q.d., every day.

Table 4 Acid-suppressive therapy and other medications

Factor	Group 1 (bacteraemia) (n = 92) (%)	Group 2 (non-bacteraemia) (n = 92) (%)	P
PPIs use, n (%)	64 (69.6)	44 (47.8)	0.004
Antibacterial prophylaxis, n (%)	35 (38.0)	54 (58.7)	0.008
Steroid use, n (%)	24 (26.1)	22 (23.9)	0.865

Table 5 Prophylaxis and the causative pathogen of bacteraemia

Causative pathogen	Prophylaxis (n = 35)	Non-prophylaxis (n = 57)	P
Gram-negative, n (%)	25 (71.4)	51 (89.5)	0.177
Gram-positive, n (%)	5 (14.3)	4 (7.0)
Complex bacteraemia, n (%)	5 (14.3)	2 (3.5)

Table 6 PPIs use and gut-derived bacteraemia: multivariable logistic regression analysis

Factor	Multivariable P-value
Age	0.394
Male	0.269
Status of malignancy (CR)	0.149
Length of neutropenia	0.806
Diabetes mellitus	0.397
Hepatitis B	0.234
PPIs use	0.000
Antibacterial prophylaxis	0.000
Steroid use	0.334