Characteristics and outcomes of cancer patients with infection in an intensive care unit
DOI:
https://doi.org/10.33448/rsd-v11i9.31452Keywords:
Intensive care unit; Cancer; Infection; Sepsis; Oncology.Abstract
Introduction: Cancer remains among the leading causes of death. Due to its characteristics and the high aggressiveness of the treatment, the need for intensive care is common. A significant part of admissions to intensive care units (ICU) can be associated with infections, with sepsis being the main complication. Thus, it is important to know the epidemiological profile for early diagnosis and adequate management, avoiding unfavorable outcomes. Objective: To characterize clinical aspects, cultures performed and outcomes identified in cancer patients admitted to an oncology ICU. Method: A descriptive, retrospective observational study with cancer patients admitted to the ICU of a cancer hospital diagnosed with infection between March 1 and July 31, 2021. Patients with solid or hematological cancer, over 18 years of age, of both sexes, hospitalized in the ICU for more than 24 hours and diagnosed with infection. Results: Of the 124 patients, 75% were diagnosed with infection. 51.6% were female and the mean age was 57 ±16 years. The mean length of stay was 10 ±11 days, with respiratory causes as the main reason (42.9%). The main focus of infection was the respiratory tract (43.9%). 45.9% had sepsis and 18.4% had septic shock. The most common microorganisms were gram-negative bacteria (58.6%). 28 of the microorganisms were multiresistant. Conclusion: A high occurrence of infection and a high mortality rate were identified, which may be related to infections or cancer treatment and/or advanced stage of cancer. A high amount of multidrug-resistant bacteria was identified, highlighting the importance of the rational use of antimicrobials.
References
Abdel-Rahman, O. (2020). Prevalence and healthcare utilization of acute respiratory infections among cancer survivors in the United States: a population based study. Https://Doi.Org/10.1080/17476348.2021.1865811, 15(5), 697–704. https://doi.org/10.1080/17476348.2021.1865811
Abou Dagher, G., El Khuri, C., Chehadeh, A. A. H., Chami, A., Bachir, R., Zebian, D., & Bou Chebl, R. (2017). Are patients with cancer with sepsis and bacteraemia at a higher risk of mortality? A retrospective chart review of patients presenting to a tertiary care centre in Lebanon. BMJ Open, 7(3), 1–8. https://doi.org/10.1136/bmjopen-2016-013502
AbuSara, A. K., Nazer, L. H., & Hawari, F. I. (2019). ICU readmission of patients with cancer: Incidence, risk factors and mortality. Journal of Critical Care, 51, 84–87. https://doi.org/10.1016/j.jcrc.2019.02.008
Anderson, E. J. (2014). Respiratory Infections. Infectious Complications in Cancer Patients, 161, 203. https://doi.org/10.1007/978-3-319-04220-6_7
Assi, H. I., Halim, N. A., Alameh, I., Khoury, J., Nahra, V., Sukhon, F., Charafeddine, M., El Nakib, C., Moukalled, N., Bou Zerdan, M., & Bou Khalil, P. (2021). Outcomes of Patients with Malignancy Admitted to the Intensive Care Units: A Prospective Study. Critical Care Research and Practice, 2021. https://doi.org/10.1155/2021/4792309
Batra, U., Goyal, P., Jain, P., Upadhyay, A., Sachdeva, N., Agarwal, M., Bhurani, D., Talwar, V., Gupta, S. K., & Doval, D. C. (2016). Epidemiology and resistance pattern of bacterial isolates among cancer patients in a Tertiary Care Oncology Centre in North India. Indian Journal of Cancer, 53(3), 448–451. https://doi.org/10.4103/0019-509X.200647
Cornejo-Juárez, P., Vilar-Compte, D., Pérez-Jiménez, C., Ñamendys-Silva, S. A., Sandoval-Hernández, S., & Volkow-Fernández, P. (2015). The impact of hospital-acquired infections with multidrug-resistant bacteria in an oncology intensive care unit. International Journal of Infectious Diseases, 31, e31–e34. https://doi.org/10.1016/j.ijid.2014.12.022
Cunha, D. A. de O. da, Cunha, R. L. da, Santos, M. L. S. C. dos, Oliveira, E. M. de, Soares, R. D. S., & Fuly, P. D. S. C. (2018). Perfil dos pacientes admitidos em uma unidade de Terapia Intensiva Oncológica/ Profile of patients admitted in a oncological Intensive Therapy Unit. Ciência, Cuidado e Saúde, 17(2), 1–8. https://doi.org/10.4025/cienccuidsaude.v17i2.40365
Goulden, R., Hoyle, M.-C., Monis, J., Railton, D., Riley, V., Martin, P., Martina, R., & Nsutebu, E. (2018). qSOFA, SIRS and NEWS for predicting inhospital mortality and ICU admission in emergency admissions treated as sepsis. Emergency Medicine Journal, 35(6), 345–349. https://doi.org/10.1136/emermed-2017-207120
Gudiol, C., Aguado, J. M., & Carratalà, J. (2016). Bloodstream infections in patients with solid tumors. Virulence, 7(3), 298–308. https://doi.org/10.1080/21505594.2016.1141161
Hawari, F. I., Nazer, L. H., Addassi, A., Rimawi, D., & Jamal, K. (2016). Predictors of ICU Admission in Patients with Cancer and the Related Characteristics and Outcomes: A 5-Year Registry-Based Study. Critical Care Medicine, 44(3), 548–553. https://doi.org/10.1097/CCM.0000000000001429
Marín, M., Gudiol, C., Garcia-Vidal, C., Ardanuy, C., & Carratalà, J. (2014). Bloodstream infections in patients with solid tumors: Epidemiology, antibiotic therapy, and outcomes in 528 episodes in a single cancer center. Medicine (United States), 93(3), 143–149. https://doi.org/10.1097/MD.0000000000000026
Mert, D., Ceken, S., Iskender, G., Iskender, D., Merdin, A., Duygu, F., Ertek, M., & Altuntas, F. (2019). Epidemiology and mortality in bacterial bloodstream infections in patients with hematologic malignancies. The Journal of Infection in Developing Countries, 13(08), 727–735. https://doi.org/10.3855/jidc.11457
Mert, D., Muslu, S., Merdin, A., Timuroğlu, A., Dirim, E., Ünver, S., & Ertek, M. (2020). Five-year period evaluation of isolated agents and their resistance profiles in intensive care unit patients with malignancy. Journal of Infection in Developing Countries, 14(8), 918–923. https://doi.org/10.3855/jidc.12219
Mirouse, A., Vigneron, C., Llitjos, J.-F., Chiche, J.-D., Mira, J.-P., Mokart, D., Azoulay, E., & Pène, F. (2020). Sepsis and Cancer: An Interplay of Friends and Foes. American Journal of Respiratory and Critical Care Medicine, 202(12), 1625–1635. https://doi.org/10.1164/rccm.202004-1116TR
Montassier, E., Batard, E., Gastinne, T., Potel, G., & De La Cochetière, M. F. (2013). Recent changes in bacteremia in patients with cancer: A systematic review of epidemiology and antibiotic resistance. European Journal of Clinical Microbiology and Infectious Diseases, 32(7), 841–850. https://doi.org/10.1007/s10096-013-1819-7
Seo, S. K., Liu, C., & Dadwal, S. S. (2021). Infectious Disease Complications in Patients with Cancer. Critical Care Clinics, 37(1), 69–84. https://doi.org/10.1016/j.ccc.2020.09.001
Soares, Marcio, Bozza, F. A., Azevedo, L. C. P., Silva, U. V. A., Corrêa, T. D., Colombari, F., Torelly, A. P., Varaschin, P., Viana, W. N., Knibel, M. F., Damasceno, M., Espinoza, R., Ferez, M., Silveira, J. G., Lobo, S. A., Moraes, A. P. P., Lima, R. A., De Carvalho, A. G. R., Do Brasil, P. E. A. A., & Salluh, J. I. F. (2016). Effects of organizational characteristics on outcomes and resource use in patients with cancer admitted to intensive care units. Journal of Clinical Oncology, 34(27), 3315–3324. https://doi.org/10.1200/JCO.2016.66.9549
Soares, Márcio, Caruso, P., Silva, E., Teles, J. M. M., Lobo, S. M. A., Friedman, G., Dal Pizzol, F., Mello, P. V. C., Bozza, F. A., Silva, U. V. A., Torelly, A. P., Knibel, M. F., Rezende, E., Netto, J. J., Piras, C., Castro, A., Ferreira, B. S., Réa-Neto, Á., Olmedo, P. B., & Salluh, J. I. F. (2010). Chracteristics and outcomes of patients with cancer requiring admission to intensive care units: A prospective multicenter study. Critical Care Medicine, 38(1), 9–15. https://doi.org/10.1097/CCM.0b013e3181c0349e
Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2021). Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 71(3), 209–249. https://doi.org/10.3322/caac.21660
Taccone, F. S., Artigas, A. A., Sprung, C. L., Moreno, R., Sakr, Y., & Vincent, J. L. (2009). Characteristics and outcomes of cancer patients in European ICUs. Critical Care, 13(1), 1–10. https://doi.org/10.1186/cc7713
Torres, V. B. L., Vassalo, J., Silva, U. V. A., Caruso, P., Torelly, A. P., Silva, E., Teles, J. M. M., Knibel, M., Rezende, E., Netto, J. J. S., Piras, C., Azevedo, L. C. P., Bozza, F. A., Spector, N., Salluh, J. I. F., & Soares, M. (2016). Outcomes in Critically Ill Patients with Cancer-Related Complications. PLOS ONE, 11(10), e0164537. https://doi.org/10.1371/journal.pone.0164537
Yang, Y., & West-Strum, D. (2010). Understanding Pharmacoepidemiology (1st ed.). McGraw Hill Professional.
Zembower, T. R. (2014). Epidemiology of Infections in Cancer Patients. In Cancer Treatment and Research (Vol. 161, pp. 43–89). https://doi.org/10.1007/978-3-319-04220-6_2
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Bruno de Almeida Ribeiro; Yasmin Coutinho dos Santos ; Maria Teresita Del Nino Jesus Fernandez Bendicho; Luana Santana Bacelar; Patrícia Lima de Araújo; Rosa Malena Fagundes Xavier
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
