Aslam Seemal, Abbas Salma, Nizamuddin Summiya, Shehbaz Muhammad, Parveen Azra, Sultan Faisal, Raza Aun
Fellow Infectious Diseases, Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.
Consultant Internal Medicine & Infectious Diseases, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.
Access Microbiol. 2024 May 14;6(5). doi: 10.1099/acmi.0.000719.v3. eCollection 2024.
Enteric fever is a significant health concern in endemic countries. While extensive research has been conducted to understand its presentation and outcomes in non-cancer patients, limited data exist on its impact on cancer patients. This descriptive study aims to investigate the clinical presentation and outcome in cancer patients. This retrospective observational study analysed 90 adult cancer patients from a single centre in Pakistan from January 2017 to December 2022. Inclusion criteria involved documented blood culture infections with or A, B, or C. We examined clinical presentation, laboratory parameters, antimicrobial resistance, complications, and outcomes. Additionally, we explored the effects of chemotherapy, comorbidities, type of malignancy, and patient age on complications and mortality. was the most prevalent organism (72.2 %), followed by A (22.2 %) and B (5.5 %). Variably-resistant isolates constituted 51.5 %, multi-drug resistant (MDR) isolates accounted for 20 %, extensively drug-resistant (XDR) for 14.4 % and ESBL-producers for 15.5 %, of all enteric fever infections. Enteric fever-associated complications were observed in 21.1 % of cases. Chemotherapy in the preceding month did not affect mortality, nor did age, gender, or malignancy type. However, comorbidities were statistically significant for mortality (-value 0.03). A total of 8.8 % of patients required ICU care, and the all-cause 30 day mortality rate was 13.3 % Enteric fever remains prevalent in our geographical region. Unlike non-typhoidal (NTS), enteric fever does not behave differently in an immunocompromised population, including cancer patients.
在流行国家,肠热病是一个重大的健康问题。虽然已经进行了广泛的研究来了解其在非癌症患者中的表现和结局,但关于其对癌症患者影响的数据有限。这项描述性研究旨在调查癌症患者的临床表现和结局。这项回顾性观察性研究分析了2017年1月至2022年12月期间来自巴基斯坦一个单一中心的90名成年癌症患者。纳入标准包括记录在案的血液培养感染,感染病原体为甲型、乙型或丙型副伤寒杆菌。我们检查了临床表现、实验室参数、抗菌药物耐药性、并发症和结局。此外,我们还探讨了化疗、合并症、恶性肿瘤类型和患者年龄对并发症和死亡率的影响。甲型副伤寒杆菌是最常见的病原体(72.2%),其次是乙型副伤寒杆菌(22.2%)和丙型副伤寒杆菌(5.5%)。在所有肠热病感染中,可变耐药菌株占51.5%,多重耐药(MDR)菌株占20%,广泛耐药(XDR)菌株占14.4%,产超广谱β-内酰胺酶(ESBL)菌株占15.5%。21.1%的病例观察到肠热病相关并发症。前一个月的化疗对死亡率没有影响,年龄、性别或恶性肿瘤类型也没有影响。然而,合并症对死亡率具有统计学意义(P值为0.03)。共有8.8%的患者需要重症监护病房护理,全因30天死亡率为13.3%。肠热病在我们的地理区域仍然很普遍。与非伤寒沙门氏菌(NTS)不同,肠热病在包括癌症患者在内的免疫功能低下人群中的表现没有差异。