title: Etiology, clinical course and outcome of healthcare-associated bloodstream infections in patients with hematological malignancies: a retrospective study of 350 patients in a Finnish tertiary care hospital.
abstract: This retrospectively collected laboratory-based surveillance data includes 575 healthcare-associated bloodstream infections (BSIs) in 350 patients with hematological malignancy in Tampere University Hospital, Finland, during 1999-2001 and 2005-2010. The most common underlying diseases were acute myelogenous leukemia (n=283, 49%), followed by myeloma (n=87, 15%) and acute lymphocytic leukemia (n=76, 13%). The overall rate was 9.1 BSIs per 1000 patient-days. Gram-positive BSIs predominated and the most common pathogens were coagulase-negative staphylococci (23%), viridans streptococci (11%), enterococci (9%) and Escherichia coli (9%). Fungi caused 2% of BSIs. The 7-day and 28-day case fatalities were 5% and 10% and were highest in BSIs caused by P. aeruginosa (19% and 34%, respectively). The median age of patients with BSI has increased; it was 55.0 years during 1999-2001, compared to 59.0 years in 2005-2007 and 59.0 years in 2008-2010 (p<0.0001). Gram-positive bacteria predominated in this material. Case fatalities were low as compared to previous reports although the median age of patients increased.
authors: a Department of Internal Medicine , Tampere University Hospital , Tampere , Finland.|b University of Tampere Medical School, University of Tampere , Finland.
authors: Emilia
authors: E
authors: Åttman
authors: c Fimlab Laboratories , Tampere , Finland.
authors: Janne
authors: J
authors: Aittoniemi
authors: a Department of Internal Medicine , Tampere University Hospital , Tampere , Finland.
authors: Marjatta
authors: M
authors: Sinisalo
authors: c Fimlab Laboratories , Tampere , Finland.
authors: Risto
authors: R
authors: Vuento
authors: d Department of Infectious Disease Epidemiology , National Institute for Health and Welfare , Helsinki , Finland.
authors: Outi
authors: O
authors: Lyytikäinen
authors: d Department of Infectious Disease Epidemiology , National Institute for Health and Welfare , Helsinki , Finland.
authors: Tommi
authors: T
authors: Kärki
authors: a Department of Internal Medicine , Tampere University Hospital , Tampere , Finland.
authors: Jaana
authors: J
authors: Syrjänen
authors: a Department of Internal Medicine , Tampere University Hospital , Tampere , Finland.|b University of Tampere Medical School, University of Tampere , Finland.
authors: Reetta
authors: R
authors: Huttunen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection; D019468:Disease Management; D005260:Female; D005387:Finland / Q000453:epidemiology; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009026:Mortality; D062486:Public Health Surveillance; D012189:Retrospective Studies; D018805:Sepsis / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D062606:Tertiary Care Centers; D055815:Young Adult
keywords: Bacteraemia; healthcare-associated; hematological; incidence density