Etiology, clinical course and outcome of healthcare-associated bloodstream infections in patients with hematological malignancies: a retrospective study of 350 patients in a Finnish tertiary care hospital

Abstract

This retrospectively collected laboratory-based surveillance data includes 575 healthcare-associated bloodstream infections (BSIs) in 350 patients with hematological malignancy in Tampere University Hospital, Finland, during 1999–2001 and 2005–2010. The most common underlying diseases were acute myelogenous leukemia (n = 283, 49%), followed by myeloma (n = 87, 15%) and acute lymphocytic leukemia (n = 76, 13%). The overall rate was 9.1 BSIs per 1000 patient-days. Gram-positive BSIs predominated and the most common pathogens were coagulase-negative staphylococci (23%), viridans streptococci (11%), enterococci (9%) and Escherichia coli (9%). Fungi caused 2% of BSIs. The 7-day and 28-day case fatalities were 5% and 10% and were highest in BSIs caused by P. aeruginosa (19% and 34%, respectively). The median age of patients with BSI has increased; it was 55.0 years during 1999–2001, compared to 59.0 years in 2005–2007 and 59.0 years in 2008–2010 (p < 0.0001). Gram-positive bacteria predominated in this material. Case fatalities were low as compared to previous reports although the median age of patients increased.

Keywords::

• Bacteraemia
• healthcare-associated
• hematological
• incidence density

Acknowledgements

We are grateful to Anna-Maija Koivisto (statistician), Ilona Rainerma (study nurse), and Riitta Koponen (head nurse of the hematological ward).

Funding

This work was supported by a grant from the Medical Research Fund of Tampere University Hospital. The authors’ work was independent of the funder (the funding source had no involvement).

Potential conflicts of interest

Disclosure forms provided by the authors are available with the full text of this article at www.informahealthcare.com/lal.