Epidemiology of hospital-acquired bloodstream infections in haemato-oncology patients in Geneva, Switzerland.

IF 3.6 2区医学 Q1 INFECTIOUS DISEASES Infection Pub Date : 2025-10-01 Epub Date: 2025-04-09 DOI:10.1007/s15010-025-02524-w

Aleece MacPhail, Marie-Noëlle Chraïti, Aude Nguyen, Gaud Catho, Loic Fortchantre, Marie-Céline Zanella, Véronique Camus, Stavroula Masouridi-Levrat, Dionysios Neofytos, Zoe McQuilten, Stephan Harbarth, Niccolò Buetti

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Abstract

Background: Hospital-acquired bloodstream infections (HA-BSI), including catheter-associated bloodstream infections (CABSI), cause preventable harm in haemato-oncology patients but surveillance data are limited.

Methods: We performed a retrospective cohort study using prospectively collected data in a large hospital network in Switzerland from 2017-2022. Incidence, source, and microbiology of HA-BSI were compared between (1) haematology patients with acute leukaemia or allogeneic stem cell transplantation (2) oncology patients with solid tumour or lymphoma, and (3) general medical patients. No routine quinolone prophylaxis was prescribed.

Results: We included 320,058 patient-days and 201,081 catheter-days across two haematology, two oncology and nine non-COVID-19 general medical wards. 669 HA-BSI occurred in 547 individual patients. In haematology patients, HA-BSI incidence was 9.1/1000 patient-days (95% CI 8.2-10.3). 224/299 (75%) of episodes were "unknown/other" source. Low virulence Gram-positive organisms (coagulase-negative staphylococci, viridans Streptococci, enterococci) accounted for 232/378 (61%) HA-BSI organisms and 46/52 (88%) CABSI organisms. Compared to oncology and general medical patients, haematology patients had higher HA-BSI incidence, but a smaller proportion of infections caused by virulent organisms (Gram-negative bacteria, Staphylococcus aureus, p < 0.01).

Conclusions: In haematology patients, HA-BSI are less commonly caused by virulent Gram-negative organisms or Staphylococcus aureus compared to solid tumour and general medical patients, in the absence of quinolone prophylaxis.

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瑞士日内瓦血液肿瘤患者医院获得性血流感染的流行病学研究

背景：医院获得性血流感染（HA-BSI），包括导管相关血流感染（CABSI），对血液肿瘤患者造成可预防的伤害，但监测数据有限。方法：我们使用2017-2022年在瑞士一家大型医院网络中前瞻性收集的数据进行了一项回顾性队列研究。比较(1)血液病患者合并急性白血病或同种异体干细胞移植(2)肿瘤患者合并实体瘤或淋巴瘤(3)普通内科患者HA-BSI的发生率、来源和微生物学。未开常规喹诺酮预防处方。结果：我们纳入了2个血液科、2个肿瘤科和9个非covid -19普通病房的320,058个患者日和201,081个导管日。547例患者发生669例HA-BSI。在血液病患者中，HA-BSI发生率为9.1/1000患者-天（95% CI 8.2-10.3）。224/299集（75%）是“未知/其他”来源。低毒力革兰氏阳性菌（凝固酶阴性葡萄球菌、翠绿链球菌、肠球菌）占232/378 (61%)HA-BSI菌和46/52 (88%)CABSI菌。与肿瘤科和普通内科患者相比，血液科患者HA-BSI发生率较高，但由毒性生物（革兰氏阴性菌、金黄色葡萄球菌）引起的感染比例较小。结论：与实体瘤和普通内科患者相比，在没有喹诺酮类药物预防的情况下，血液科患者HA-BSI较少由毒性革兰氏阴性菌或金黄色葡萄球菌引起。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.