Department of Infectious Diseases, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo-ku, Tokyo, Japan.
Library, Department of Academic Resources, St. Luke's International University, Tokyo, Japan.
Int J Hematol. 2023 Dec;118(6):726-730. doi: 10.1007/s12185-023-03671-2. Epub 2023 Oct 17.
The mortality risk factors in B. cereus bacteremia in hematologic disorders are still unknown. In this study, patients with B. cereus bacteremia in hematologic disorders were selected in St. lukes international hospital and from electronic databases. A total of 176 patients [median age, 41 years (3-88 years); 99 (56%) males] were included. Of these patients, 141 (80%) had acute leukemia, and 93 (53%) died. Univariate analysis showed that neutropenia, CNS, gastrointestinal, and respiratory infections/symptoms were significantly associated with infection-related death. Meanwhile, glycopeptide use and management with source control were protective factors. Multivariate logistic regression analysis showed that infection-related death was significantly associated with CNS [odds ratio (OR): 3.49, 95% confidence interval (CI) 1.25-9.80], gastrointestinal (OR: 5.22, 95% CI 1.82-8.99), and respiratory infections/symptoms (OR: 8.98, 95% CI 1.62-49.9), as well as glycopeptide use (OR: 0.10, 95% CI 0.03-0.31) and source control (OR: 0.11, 95% CI 0.03-0.37). In conclusion, early glycopeptide administration and source control should be performed upon detection of infections suspicious for B. cereus.
血液系统疾病中蜡样芽胞杆菌菌血症的死亡危险因素尚不清楚。本研究在圣卢克国际医院和电子数据库中选择了血液系统疾病中蜡样芽胞杆菌菌血症的患者。共纳入 176 例患者[中位年龄 41 岁（3-88 岁）；99 例（56%）为男性]。这些患者中，141 例（80%）患有急性白血病，93 例（53%）死亡。单因素分析显示，中性粒细胞减少、中枢神经系统、胃肠道和呼吸道感染/症状与感染相关死亡显著相关。同时，糖肽类药物的使用和源头控制管理是保护因素。多因素逻辑回归分析显示，感染相关死亡与中枢神经系统（比值比[OR]：3.49，95%置信区间[CI]：1.25-9.80）、胃肠道（OR：5.22，95% CI：1.82-8.99）和呼吸道感染/症状（OR：8.98，95% CI：1.62-49.9）显著相关，糖肽类药物的使用（OR：0.10，95% CI：0.03-0.31）和源头控制（OR：0.11，95% CI：0.03-0.37）也显著相关。总之，一旦怀疑感染蜡样芽胞杆菌，应尽早给予糖肽类药物和进行源头控制。
