Clinical features and outcome of Aeromonas sobria bacteremia in pediatric and adult patients with hematologic malignancies: A single-center retrospective study in Peru

PLoS One. 2021 Aug 11;16(8):e0255910. doi: 10.1371/journal.pone.0255910. eCollection 2021.

Abstract

Background: Previous studies have found that healthcare-associated bacteremia (HAB) by Aeromonas species is associated with mortality. However, there is limited data on this outcome in patients with hematologic malignancies. This study aimed to identify the clinical features of patients with malignant hematologic diseases diagnosed with Aeromonas sobria bacteremia and to evaluate whether the type of bacteremia, community-acquired bacteremia (CAB) or HAB, is associated with mortality.

Methods: We retrospectively reviewed the clinical records of pediatric and adult patients between January 2000 and December 2017. Clinical characteristics were compared between CAB and HAB. Additionally, we stratified based on age group. Survival outcomes were assessed with Kaplan-Meier curves and a multivariate Cox regression analysis.

Results: A total of 37 patients (median age 24 years) were identified; 23 (62%) had HAB and 14 (38%) had CAB. Overall, the most common presenting symptom was abdominal pain (41%). Acute lymphoblastic leukemia (n = 12/15, 80%) and acute myeloid leukemia (n = 8/22, 36%) were the primary hematologic malignancies in pediatric and adult patients, respectively. CAB patients had worse overall survival (OS) rates at 30 days in all (43% versus HAB 91%, p = 0.006) and adult patients (30% versus HAB 92%, p = 0.002). Cox regression analysis found that quick Sequential Organ Failure Assessment and CAB were statistically significant factors associated with mortality. Low antimicrobial-resistant was noted, except for ciprofloxacin (n = 5/37, 14%).

Conclusion: Our study found a worse OS among patients with hematologic malignancies and CAB by Aeromonas sobria. Our results suggest that patients with CAB present with a worse disease severity. These findings should aid clinicians to determine the survival prognosis in this population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aeromonas / drug effects
  • Aeromonas / isolation & purification*
  • Aged
  • Bacteremia / complications
  • Bacteremia / microbiology
  • Bacteremia / mortality
  • Bacteremia / pathology*
  • Child
  • Child, Preschool
  • Ciprofloxacin / pharmacology
  • Cross Infection / complications
  • Cross Infection / microbiology
  • Cross Infection / mortality
  • Cross Infection / pathology
  • Drug Resistance, Bacterial / drug effects
  • Female
  • Hematologic Neoplasms / complications
  • Hematologic Neoplasms / pathology*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multiple Organ Failure
  • Peru
  • Proportional Hazards Models
  • Retrospective Studies
  • Young Adult

Substances

  • Ciprofloxacin

Supplementary concepts

  • Aeromonas sobria

Grants and funding

The funding source is the “Universidad Científica del Sur”, which supports only the financial aspect of the study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. None of the authors received a salary from the “Universidad Científica del Sur” to develop this study.