4.7 Article

Clinical Characteristics of Bloodstream Infection in Immunosuppressed Patients: A 5-Year Retrospective Cohort Study

Journal

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fcimb.2022.796656

Keywords

bloodstream infection; different subgroups; mortality; immunosuppressive states; prognosis

Funding

  1. National Natural Science Foundation of China [8217010254, 82170086]
  2. Shanghai Shenkang Hospital Development Center Clinical Science and Technology Innovation Project [SHDC12018102]
  3. Shanghai Municipal Key Clinical Specialty [shslczdzk02202]
  4. Shanghai Key Laboratory of Emergency Prevention, Diagnosis and Treatment of Respiratory Infectious Diseases [20dz2261100]

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This study assessed the independent risk factors of mortality in immunosuppressed patients with bloodstream infection. Age and PCT were identified as key factors associated with mortality in immunosuppressive states.
IntroductionImmunosuppressed patients with bloodstream infection are at risk of mortality. Our objective was to assess the independent risk factors of bloodstream infection with mortality in immunosuppressive states. MethodsThe medical data of a total of 896 patients who were hospitalized in our hospital were collected from January 2015 to December 2019. Evaluation of the independent risk factors of mortality was done by univariate and multivariate logistic regression analyses. ResultsOf the 896 immunosuppressed patients with bloodstream infection, 698 had over 60-day survivals and 198 had 60-day mortality. In our study, PCT (mean +/-; standard: 11.40 +/-; 31.89 mu g/l vs. 62.45 +/-; 17.10 mu g/l, p = 0.007) and presence of age >60 years (40% vs. 14.19%, p = 0.001) were significantly different between situations with and without 60-day survivals in both univariate and multivariate logistic regression analyses. Age >60 years and PCT could be used as indicators for bloodstream infection with 60-day death in immunosuppressive states; the OR (95% CI) were 1.532 (1.099-2.135) and 2.063 (1.413-3.013), respectively. In different subgroups, PCT and age were also independent risk factors of blood system diseases, Klebsiella pneumoniae infection, diabetes, and ICU-stay subgroups. ConclusionsAge and PCT were independently associated with mortality in immunosuppressive states, which may help to identify the highly risky situation of bloodstream infection in immunosuppressive states.

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