Universität zu Köln

Camp, Johannes, Filla, Tim, Glaubitz, Lina, Kaasch, Achim J., Fuchs, Frieder ORCID: 0000-0001-7075-5378, Scarborough, Matt, Kim, Hong Bin ORCID: 0000-0001-6262-372X, Tilley, Robert, Liao, Chun-Hsing, Edgeworth, Jonathan, Nsutebu, Emmanuel, Lopez-Cortes, Luis Eduardo, Morata, Laura ORCID: 0000-0001-5795-0814, Llewelyn, Martin J., Fowler, Vance G., Thwaites, Guy, Seifert, Harald, Kern, Winfried, V and Rieg, Siegbert (2022). Impact of neutropenia on clinical manifestations and outcome of Staphylococcus aureus bloodstream infection: a propensity score-based overlap weight analysis in two large, prospectively evaluated cohorts. Clin. Microbiol. Infect., 28 (8). OXFORD: ELSEVIER SCI LTD. ISSN 1469-0691

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Abstract

Objectives: This study aimed to investigate whether neutropenia influenced mortality and long-term outcomes of Staphylococcus aureus bloodstream (SAB) infection. Methods: Data from two prospective, multicentre cohort studies (INSTINCT and ISAC) conducted at 20 tertiary care hospitals in six countries between 2006 and 2015 were analyzed. Neutropenic and severely neutropenic patients (defined by proxy of total white blood cell count <1000/mu l and <500/mu l, respectively, at onset of SAB infection) were compared with a control group using a propensity score model and overlapping weights to adjust for baseline characteristics. Overall survival and time to SAB infection- related late complications (SAB infection recurrence, infective endocarditis, osteomyelitis, or other deepseated manifestations) were analyzed with Cox regression and competing risk analyses, respectively. Results: Of the 3187 included patients, 102 were neutropenic and 70 severely neutropenic at the time of SAB infection onset. Applying overlap weights yielded two groups of 83 neutropenic and 220 non-neutropenic patients, respectively. The baseline characteristics of these groups were exactly balanced. In the Cox regression analysis, we observed no significant difference in survival between the two groups (death during follow up: 36.1% in neutropenic vs. 30.6% in nonneutropenic patients; hazard ratio (HR): 1.21; 95% CI, 0.79-1.83). This finding remained unchanged when we considered severely neutropenic patients (HR: 1.08; 95% CI, 0.60-1.94). A competing risk analysis showed a cause-specific HR of 0.39 (95% CI, 0.11-1.39) for SAB infection-related late complications in neutropenic patients. Discussion: Neutropenia was not associated with a higher survival rate during follow up. The lower rate of SAB infection-related late complications in neutropenic patients should be validated in other cohorts. (C) 2022 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Camp, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Filla, Tim UNSPECIFIED UNSPECIFIED UNSPECIFIED Glaubitz, Lina UNSPECIFIED UNSPECIFIED UNSPECIFIED Kaasch, Achim J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuchs, Frieder UNSPECIFIED orcid.org/0000-0001-7075-5378 UNSPECIFIED Scarborough, Matt UNSPECIFIED UNSPECIFIED UNSPECIFIED Kim, Hong Bin UNSPECIFIED orcid.org/0000-0001-6262-372X UNSPECIFIED Tilley, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Liao, Chun-Hsing UNSPECIFIED UNSPECIFIED UNSPECIFIED Edgeworth, Jonathan UNSPECIFIED UNSPECIFIED UNSPECIFIED Nsutebu, Emmanuel UNSPECIFIED UNSPECIFIED UNSPECIFIED Lopez-Cortes, Luis Eduardo UNSPECIFIED UNSPECIFIED UNSPECIFIED Morata, Laura UNSPECIFIED orcid.org/0000-0001-5795-0814 UNSPECIFIED Llewelyn, Martin J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fowler, Vance G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Thwaites, Guy UNSPECIFIED UNSPECIFIED UNSPECIFIED Seifert, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Kern, Winfried, V UNSPECIFIED UNSPECIFIED UNSPECIFIED Rieg, Siegbert UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-696794
DOI:	10.1016/j.cmi.2022.03.018
Journal or Publication Title:	Clin. Microbiol. Infect.
Volume:	28
Number:	8
Date:	2022
Publisher:	ELSEVIER SCI LTD
Place of Publication:	OXFORD
ISSN:	1469-0691
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HEMATOLOGIC MALIGNANCIES; BACTEREMIA; SURVIVAL Multiple languages Infectious Diseases; Microbiology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69679