Epidemiology, clinical characteristics, and outcome of bloodstream infections in patients with solid tumors

2020 Fiscal Year Final Research Report

• Project/Area Number: 18K14979
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 47060:Clinical pharmacy-related
• Research Institution: University of Fukui
• Principal Investigator: Hitoshi Tsukamoto 福井大学, 学術研究院医学系部門(附属病院部), 講師 (60600880)
• Project Period (FY): 2018-04-01 – 2021-03-31
• Keywords: 固形腫瘍 / 血流感染症 / 分離菌 / 経年的変化 / 予後因子

Outline of Final Research Achievements

Using the information from electronic medical records for 799 patients with solid tumors who developed bloodstream infections between 2012 and 2019, we studied the secular changes, clinical features, outcomes, and prognostic factors of microbial isolates. The isolates included 49% Gram-negative bacteria, 40% Gram-positive bacteria, 7% fungi, and 4% anaerobic bacteria, with 52 patients (6.5%) being polymicrobial. The most common species was Escherichia coli, followed by Klebsiella spp. and then enterococci. There was no secular change in the distribution of isolates during the study period. Independent risk factors associated with death within 30 days were severity (Pitt bacteremia score), Charlson comorbidity index, and the delay in the administration of appropriate antibiotics.

Free Research Field

医療薬学

Academic Significance and Societal Importance of the Research Achievements

悪性腫瘍患者には比較的安易に広域抗菌薬を使用する傾向が強く、不要な広域抗菌薬の乱用に繋がっている可能性もある。適切な抗菌薬治療を考える上で起炎菌等に関する細菌学的データは不可欠であるが、固形腫瘍瘍患者の感染症を対象とした疫学データはほとんどない。がん化学療法が著しい進歩を遂げている中で、本研究によって起炎菌の全体像や経年的変化が明らかになれば抗菌薬適正使用を推進していく上で有益なデータとなる。さらに、収集した臨床背景データを利用して予後因子が解明出来れば、より質の高い感染症診療を提供することができる。