Patterns of Infections in Hospitalized Patients With Cancer

Preparing a hospitalized patient for therapy.
Preparing a hospitalized patient for therapy.
Infections in the GI tract and the blood were common among patients with hematologic malignancies and solid tumor neoplasms, according to results of a retrospective analysis of hospitalized patients with primary malignant neoplasms.

A retrospective analysis revealed that infections in the gastrointestinal (GI) tract and the blood were common among patients with hematologic malignancies (HMs) and solid tumor neoplasms (STNs). The results of the analysis were recently published in Supportive Care in Cancer.

The analysis was a longitudinal cohort study conducted at the Peter MacCallum Cancer Centre in Victoria, Australia, involving 45,116 inpatient hospital admissions. The study investigators evaluated infection rates and outcomes in 21,405 hospitalized patients who had primary malignant neoplasms.

A total of 18,372 patients had STNs, and 3033 had HMs, of whom 953 had received autologous hematopoietic stem cell transplantation (autoHSCT). Among patients with STNs, 5406 (29%) had infectious disease diagnoses, while infections were found in 1997 (66%) patients with HMs and in 840 (88%) autoHSCT recipients.

The prevalence of infection was highest in patients with acute myeloid leukemia (85%) and multiple myeloma (78%). Infections were most common with cancers of the heart, mediastinum, and pleura (56%) or bone and articular cartilage of the limbs (53%) among patients with STNs.

Related Articles

The sites that most commonly became infected were the GI tract, the bloodstream, and the lower respiratory tract. In patients with HMs, infection incidence was highest among patients in the age group of 60 to 69 years, whereas for patients with STNs the 18- to 29-year age group experienced the most infections. Patients with STNs showed an increased risk of in-hospital mortality in association with becoming infected (P <.001); patients with HMs showed a similar but nonsignificant trend (P =.166).

The researchers concluded that infection rates were high in this population and particularly in association with certain malignancies. “Our findings support the need to maintain good monitoring and prevention strategies,” the study investigators concluded in their report.

Reference

Valentine JC, Hall L, Spelman T, et al. Burden and clinical outcomes of hospital-coded infections in patients with cancer: an 11-year longitudinal cohort study at an Australian cancer centre [published online April 15, 2020]. Support Care Cancer. doi:10.1007/s00520-020-05439-4