Kitaya Shiori, Kakuta Risako, Kanamori Hajime, Ohkoshi Akira, Ishii Ryo, Nomura Kazuhiro, Tokuda Koichi, Katori Yukio
Department of Otolaryngology, Head and Neck Surgery, Tohoku University Hospital, Sendai 980-8574, Japan.
Department of Infectious Diseases, Internal Medicine, Tohoku University Hospital, Sendai 980-8574, Japan.
J Clin Med. 2022 Aug 17;11(16):4820. doi: 10.3390/jcm11164820.
This retrospective study aims to describe the clinico-epidemiological characteristics of bloodstream infections (BSIs) and the risk factors in patients with head and neck cancer ( = 227) treated at the Department of Otolaryngology, Head and Neck Surgery, Tohoku University Hospital between April 2011 and March 2021. Overall, 23.3% of blood cultures were positive. In the culture-positive group, catheter-related bloodstream infections (CRBSIs) were the most common (38.8%), followed by respiratory tract infections (19.4%), and catheter-associated urinary tract infections (6.0%). Methicillin-resistant (26.9%), (17.9%), and (10.4%) infections were common. The most frequent treatment for head and neck cancer was surgery (23.9%), followed by treatment interval or palliative care (19.4%), and single radiotherapy (13.4%). The 30-day mortality rate was significantly higher in the BSI than in the non-BSI group (10.4% vs. 1.8%, respectively). CRBSIs are the most frequent source of BSIs in patients with head and neck cancer. In conclusion, central venous catheters or port insertion should be used for a short period to prevent CRBSIs. The risk of developing BSI should be considered in patients with pneumonia. Understanding the epidemiology of BSIs is crucial for diagnosing, preventing, and controlling infections in patients with head and neck cancer.
本回顾性研究旨在描述2011年4月至2021年3月在东北大学医院耳鼻咽喉头颈外科接受治疗的头颈癌患者(n = 227)血流感染(BSIs)的临床流行病学特征及危险因素。总体而言,23.3%的血培养呈阳性。在培养阳性组中,导管相关血流感染(CRBSIs)最为常见(38.8%),其次是呼吸道感染(19.4%)和导管相关尿路感染(6.0%)。耐甲氧西林金黄色葡萄球菌(26.9%)、肺炎克雷伯菌(17.9%)和大肠埃希菌(10.4%)感染较为常见。头颈癌最常见的治疗方式是手术(占23.9%),其次是治疗间歇期或姑息治疗(占19.4%),以及单纯放疗(占13.4%)。BSI组的30天死亡率显著高于非BSI组(分别为10.4%和1.8%)。CRBSIs是头颈癌患者BSIs最常见的来源。总之,应短期使用中心静脉导管或置入端口以预防CRBSIs。肺炎患者应考虑发生BSI的风险。了解BSIs流行病学对于头颈癌患者感染的诊断、预防和控制至关重要。