TY - JOUR
T1 - Increased incidence rates of positive blood cultures shortly after chemotherapy compared to radiotherapy among individuals treated for solid malignant tumours
AU - Roen, Ashley
AU - Terrones, Cynthia
AU - Bannister, Wendy
AU - Helleberg, Marie
AU - Andersen, Michael Asger
AU - Niemann, Carsten Utoft
AU - Daugaard, Gedske
AU - Specht, Lena
AU - Mocroft, Amanda
AU - Reekie, Joanne
AU - Lundgren, Jens
N1 - © 2022. The Author(s).
PY - 2023/2
Y1 - 2023/2
N2 - BACKGROUND: Cancer treatments suppress immune function and are associated with increased risk of infections, but the overall burden of serious infectious diseases in treated patients has not been clearly elucidated.METHODS: All patients treated for solid malignant tumours with radiotherapy (RT) and/or standard first-line chemotherapy (C) at the Department of Oncology at Rigshospitalet between 01/1/2010 and 31/12/2016 were included. Patients were followed from treatment initiation until the first of new cancer treatment, 1 year after treatment initiation, end of follow-up or death. Incidence rates (IR) of positive blood culture (PBC) per 1000 person-years follow-up (PYFU) were calculated.FINDINGS: 12,433 individuals were included, 3582 (29%), 6349 (51%), and 2502 (20%) treated with RT, C, or both RT & C, respectively, contributing 8182 PYFU. 429 (3%) individuals experienced 502 unique episodes of PBC, incidence rate (95% CI) 52.43 (47.7, 57.6) per 1000 PYFU. The 30-day mortality rate after PBC was 24% independent of treatment modality. Adjusted incidence rate ratios in the first 3 months (95% CI) after PBC significantly varied by treatment: 2.89 (1.83, 4.55) and 2.52 (1.53, 4.14) for C and RT & C compared to RT. Escherichia coli (n = 127, 25%) was the top microorganism identified.INTERPRETATION: PBCs are not common, but when they occur, mortality is high.
AB - BACKGROUND: Cancer treatments suppress immune function and are associated with increased risk of infections, but the overall burden of serious infectious diseases in treated patients has not been clearly elucidated.METHODS: All patients treated for solid malignant tumours with radiotherapy (RT) and/or standard first-line chemotherapy (C) at the Department of Oncology at Rigshospitalet between 01/1/2010 and 31/12/2016 were included. Patients were followed from treatment initiation until the first of new cancer treatment, 1 year after treatment initiation, end of follow-up or death. Incidence rates (IR) of positive blood culture (PBC) per 1000 person-years follow-up (PYFU) were calculated.FINDINGS: 12,433 individuals were included, 3582 (29%), 6349 (51%), and 2502 (20%) treated with RT, C, or both RT & C, respectively, contributing 8182 PYFU. 429 (3%) individuals experienced 502 unique episodes of PBC, incidence rate (95% CI) 52.43 (47.7, 57.6) per 1000 PYFU. The 30-day mortality rate after PBC was 24% independent of treatment modality. Adjusted incidence rate ratios in the first 3 months (95% CI) after PBC significantly varied by treatment: 2.89 (1.83, 4.55) and 2.52 (1.53, 4.14) for C and RT & C compared to RT. Escherichia coli (n = 127, 25%) was the top microorganism identified.INTERPRETATION: PBCs are not common, but when they occur, mortality is high.
KW - Chemotherapy
KW - Positive blood culture
KW - Radiotherapy
KW - Solid malignant tumours
UR - http://www.scopus.com/inward/record.url?scp=85133004765&partnerID=8YFLogxK
U2 - 10.1007/s15010-022-01863-2
DO - 10.1007/s15010-022-01863-2
M3 - Journal article
C2 - 35764910
SN - 0300-8126
VL - 51
SP - 147
EP - 157
JO - Infection
JF - Infection
IS - 1
ER -