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BMJ Open . Changing epidemiology, microbiology and mortality of bloodstream infections in patients with haematological malignancies before and durin

tetano

Editor, Senior Moderator
BMJ Open


. 2023 Dec 30;13(12):e078510.
doi: 10.1136/bmjopen-2023-078510. Changing epidemiology, microbiology and mortality of bloodstream infections in patients with haematological malignancies before and during SARS-CoV-2 pandemic: a retrospective cohort study

Linjing Cai[SUP] #[/SUP][SUP] 1 [/SUP], Huan Chen[SUP] #[/SUP][SUP] 1 [/SUP], Yongqiang Wei[SUP] 1 [/SUP], Xutao Guo[SUP] 1 [/SUP], Haiqing Zheng[SUP] 2 [/SUP], Xuejie Jiang[SUP] 1 [/SUP], Yu Zhang[SUP] 1 [/SUP], Guopan Yu[SUP] 1 [/SUP], Min Dai[SUP] 1 [/SUP], Jieyu Ye[SUP] 1 [/SUP], Hongsheng Zhou[SUP] 1 [/SUP], Dan Xu[SUP] 1 [/SUP], Fen Huang[SUP] 1 [/SUP], Zhiping Fan[SUP] 1 [/SUP], Na Xu[SUP] 1 [/SUP], Pengcheng Shi[SUP] 1 [/SUP], Li Xuan[SUP] 1 [/SUP], Ru Feng[SUP] 1 [/SUP], Xiaoli Liu[SUP] 1 [/SUP], Jing Sun[SUP] 1 [/SUP], Qifa Liu[SUP] 1 [/SUP], Xiaolei Wei[SUP] 3 [/SUP]



Affiliations
Free PMC article Abstract

Objective: This study was to explore the changes in bacterial bloodstream infection (BSI) in patients with haematological malignancies (HMs) before and during SARS-CoV-2 pandemic.
Design: Retrospective cohort study between 2018 and 2021.
Setting: The largest haematological centre in southern China.
Results: A total of 599 episodes of BSI occurring in 22 717 inpatients from January 2018 to December 2021 were analysed. The frequencies of the total, Gram-negative and Gram-positive BSI before and during the pandemic were 2.90% versus 2.35% (p=0.011), 2.49% versus 1.77% (p<0.001) and 0.27% versus 0.44% (p=0.027), respectively. The main isolates from Gram-negative or Gram-positive BSI and susceptibility profiles also changed. The 30-day mortality caused by BSI was lower during the pandemic (21.1% vs 14.3%, p=0.043). Multivariate analysis revealed that disease status, pulmonary infection and shock were independent predictors of 30-day mortality.
Conclusion: Our data showed that the incidence of total and Gram-negative organisms BSI decreased, but Gram-positive BSI incidence increased in patients with HMs during the pandemic along with the changes of main isolates and susceptibility profiles. Although the 30-day mortality due to BSI was lower during the pandemic, the new infection prevention strategy should be considered for any future pandemics.

Keywords: COVID-19; epidemiology; haematology.

 
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