Bloodstream infections in acute myeloid leukemia patients treated according to the Finnish Leukemia Group AML-2003 protocol - a prospective nationwide study

Aarne Kolonen, Marjatta Sinisalo, Reetta Huttunen, Jaana Syrjänen, Janne Aittoniemi, Heini Huhtala, Marja Sankelo, Hannele Rintala, Riikka Räty, Esa Jantunen, Tapio Nousiainen, Marjaana Säily, Marjut Kauppila, Maija Itälä-Remes, Hanna Ollikainen, Auvo Rauhala, Pirjo Koistinen, Erkki Elonen

Research output: Contribution to journalArticleScientificpeer-review

10 Citations (Scopus)

Abstract

BACKGROUND: Infections greatly influence the outcome of acute myeloid leukemia (AML) patients receiving intensive treatment. The aim of this study was to establish the incidence, microbial etiology, risk factors and prognosis of bloodstream infections (BSIs) in patients with AML and compare the results with the previous treatment protocol (AML-92).

METHODS: Registery data were gathered prospectively from 357 patients aged 16-65 years recruited on the AML-2003 treatment protocol between November 2003 and November 2011 during different treatment cycles.

RESULTS: Blood culture data were available on 977 treatment episodes, in which there were 503 BSIs (51%). The overall incidence rate (IR) for BSIs (per 1000 hospital days) was 16.7. Twenty patients (5.6%) died due to an infection and 16 of them (80%) had a BSI. The most commonly detected microbes (polymicrobial episodes included) in blood cultures were coagulase-negative staphylococci (CoNS, 24.7%), viridans group streptococci (VGS, 19.1%), enterococci (13.9%) and Enterobacteriacae group (25.9%). The etiology of BSIs varied greatly from treatment cycle to cycle.

CONCLUSIONS: Enterococcal BSIs have increased compared to our previous treatment protocol, and they represent significant pathogens in blood cultures. Infection-related mortality has decreased despite the increase in the IR of BSIs. Enterococci seem to be an increasingly prominent pathogen underlying BSIs in the AML patients, especially during induction therapy (20%).

Original languageEnglish
Pages (from-to)799-808
Number of pages10
JournalInfectious Diseases
Volume49
Issue number11-12
DOIs
Publication statusPublished - 2017
Publication typeA1 Journal article-refereed

Keywords

  • AML
  • Enterococcus
  • bacteremia
  • intensive chemotherapy
  • mortality
  • neutropenia

Publication forum classification

  • Publication forum level 1

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