Infections In Cancer Patients Research Articles

Changing patterns of bacterial profile and antimicrobial resistance in high-risk patients during the COVID-19 pandemic at a tertiary oncology hospital

Changing patterns of bacterial profile and antimicrobial resistance in high-risk patients during the COVID-19 pandemic at a tertiary oncology hospital

Research progress on risk factors for implantable venous access port-related infections in cancer patients

Research progress on risk factors for implantable venous access port-related infections in cancer patients

Screening for viral hepatitis B infection in cancer patients before receiving chemotherapy - A systematic review and meta-analysis.

We conducted a systematic review and meta-analysis to assess the hepatitis B virus (HBV) screening rate in cancer patients before systemic chemotherapy, aiming to identify those needing antiviral prophylaxis for HBV reactivation. We searched PubMed, Embase, Scopus, and Google Scholar for relevant studies. The pooled screening rate was estimated using a random effects model. Subgroup analyses were conducted based on malignancy types, chemotherapy regimens, study period, and HBV endemic regions. The meta-analysis included 29 studies from various endemic regions (19 low-endemic, three lower intermediate-endemic, and seven higher intermediate-endemic). These studies encompassed hematologic malignancies (n=10), solid-organ tumors (n=4), and combinations (n=15). Seven studies used rituximab-containing regimens, four did not, and the remaining 11 did not specify chemotherapy regimens. The pooled screening rate was 57% (95% confidence interval [95%CI]: 46%-68%, I2=100%). Over time, screening rates improved from 37% (95%CI: 23%-53%) in 2006-2010 to 68% (54%-80%) in 2011-2015 and 69% (48%-84%) in 2016-2020. Screening rates were highest at 89% (74%-96%) in high endemic countries, followed by 60% (45-73%) in lower-intermediate and 49% (34-64%) in low-endemic countries. Patients with hematological malignancies had a higher screening rate than those with solid organ tumors, 65% (55%-74%) versus 37% (21%-57%), respectively. A screening rate was higher in patients receiving rituximab-containing chemotherapy than non-rituximab regimens, 68% (55%-79%) versus 45% (27%-65%). Despite existing guidelines, pre-chemotherapy HBV screening rate remains unsatisfactory, with substantial heterogeneous rates globally. These findings underscore the need for effective strategies to align practices with clinical guidelines.

The occurrence of immune-related adverse events is an independent risk factor both for serum HBsAg increase and HBV reactivation in HBsAg-positive cancer patients receiving PD-1 inhibitor combinational therapy.

Previous studies have suggested the potential of PD-1/PD-L1 inhibitors in the treatment of chronic HBV infection. However, since phase III clinical trials have not yet been announced, additional clinical insights may be obtained by observing changes in serum hepatitis B surface antigen (HBsAg) and HBV-DNA levels in cancer patients undergoing PD-1 inhibitor therapy. To explore the effects of PD-1 inhibitor combinational therapy on serum HBsAg and HBV-DNA levels, investigate the incidence of HBsAg loss, HBV reactivation (HBVr), and immune-related adverse events (irAEs), and identify the risk factors associated with significant HBsAg fluctuations and HBVr. A retrospective study including 1195 HBsAg-positive cancer patients who received PD-1 inhibitors between July 2019 and June 2023 was conducted, and 180 patients were enrolled in this study. Serum HBsAg levels before and after PD-1 inhibitor administration were compared across different subgroups. The Pearson χ2 or Fisher exact test was performed to investigate the relationships between categorical variables. Univariable and multivariable analysis were performed to identify the risk factors associated with significant HBsAg fluctuations and HBVr. With the concurrent use of antiviral agents, serum HBsAg levels decreased (Z=-3.966, P < 0.0001) in 129 patients and increased (t=-2.047, P=0.043) in 51 patients. Additionally, 7 patients (3.89%) achieved serum HBsAg loss. Virus replication was suppressed in most of the enrolled patients. When divided patients into different subgroups, significant HBsAg decreases after PD-1 inhibitor administration were discovered in lower baseline HBsAg group (Z=-2.277, P=0.023), HBeAg-seronegative group (Z=-2.200, P=0.028), non-irAEs occurrence group (Z=-2.007, P=0.045) and liver cancer group (Z=-1.987, P=0.047). Of note, 11 patients and 36 patients experienced HBVr (6.11%) and irAEs (20%), respectively, which could lead to discontinuation or delayed use of PD-1 inhibitors. After multivariable analysis, HBeAg-seropositive (OR, 7.236 [95% CI, 1.757-29.793], P=0.01) and the occurrence of irAEs (OR, 4.077 [95% CI, 1.252-13.273], P=0.02) were identified as the independent risk factors for significant HBsAg increase, the occurrence of irAEs (OR, 5.560 [95% CI, 1.252-13.273], P=0.01) was identified as the only independent risk factor for HBVr. PD-1 inhibitors combined with nucleos(t)ide analogues (NAs) may exert therapeutic potential for chronic HBV infection in cancer patients. However, attention also should be paid to the risk of significant elevation in HBsAg levels, HBVr, and irAEs associated with PD-1 inhibitor combinational therapy.

Viral Epitope Scanning Reveals Correlation between Seasonal HCoVs and SARS-CoV-2 Antibody Responses among Cancer and Non-Cancer Patients.

Seasonal coronaviruses (HCoVs) are known to contribute to cross-reactive antibody (Ab) responses against SARS-CoV-2. While these responses are predictable due to the high homology between SARS-CoV-2 and other CoVs, the impact of these responses on susceptibility to SARS-CoV-2 infection in cancer patients is unclear. To investigate the influence of prior HCoV infection on anti-SARS-CoV-2 Ab responses among COVID-19 asymptomatic individuals with cancer and controls without cancers, we utilized the VirScan technology in which phage immunoprecipitation and sequencing (PhIP-seq) of longitudinal plasma samples was performed to investigate high-resolution (i.e., epitope level) humoral CoV responses. Despite testing positive for anti-SARS-CoV-2 Ab in the plasma, a majority of the participants were asymptomatic for COVID-19 with no prior history of COVID-19 diagnosis. Although the magnitudes of the anti-SARS-CoV-2 Ab responses were lower in individuals with Kaposi sarcoma (KS) compared to non-KS cancer individuals and those without cancer, the HCoV Ab repertoire was similar between individuals with and without cancer independent of age, sex, HIV status, and chemotherapy. The magnitudes of the anti-spike HCoV responses showed a strong positive association with those of the anti-SARS-CoV-2 spike in cancer patients, and only a weak association in non-cancer patients, suggesting that prior infection with HCoVs might play a role in limiting SARS-CoV-2 infection and COVID-19 disease severity.

Quinalizarin as a potential antifungal drug for the treatment of Candida albicans fungal infection in cancer patients.

This study aims to analyze the antifungal properties of quinalizarin, a plant-derived compound with proven anticancer effects. Quinalizarin exhibited antifungal activity against opportunistic pathogenic Candida species and Geotrichum capitatum. The treatment with this anthraquinone reduced hyphal growth, inhibited biofilm formation, and damaged mature Candida albicans biofilms. Real-time RT-PCR revealed that quinalizarin downregulated the expression of hyphae-related and biofilm-specific genes. The flow cytometry method used in the study showed that both apoptosis and necrosis were the physiological mechanisms of quinalizarin-induced C. albicans cell death, depending on the dose of the antifungal agent. A further study revealed an increase in the levels of intracellular reactive oxygen species and alterations in mitochondrial membrane potential after treatment with quinalizarin. Finally, quinalizarin was found to have low toxicity in a hemolytic test using human erythrocytes. In conclusion, we have identified quinalizarin as a potential antifungal compound.IMPORTANCEThis article is a study to determine the antifungal activity of quinalizarin (1,2,5,8-tetrahydroxyanthraquinone). Quinalizarin has potential antitumor properties and is effective in different types of tumor cells. The aim of the present study was to prove that quinalizarin can be used simultaneously in the treatment of cancer and in the treatment of intercurrent fungal infections. Quinalizarin was identified as a novel antifungal compound with low toxicity. These results may contribute to the development of a new drug with dual activity in the treatment of cancer-associated candidiasis.

In vitro activity of cefepime/taniborbactam and comparator agents against Gram-negative bacterial bloodstream pathogens recovered from patients with cancer.

Taniborbactam is a β-lactamase inhibitor that, when combined with cefepime, may offer a potential treatment option for patients with serious and resistant Gram-negative bacterial (GNB) pathogens. This study evaluated in vitro activity of cefepime/taniborbactam and comparator agents against GNB pathogens isolated from patients with cancer at our institution. A total of 270 GNB pathogens (2019-23) isolated from patients with cancer were tested against cefepime/taniborbactam and comparator agents commonly used for these patients. CLSI-approved broth microdilution methods were used. MIC50, MIC90, MIC range and percentage of susceptibility calculations were made using FDA breakpoints when available. Cefepime/taniborbactam showed highly potent activity against tested Enterobacterales, including isolates producing ESBLs and carbapenem-resistant Enterobacterales. At a provisional breakpoint of ≤16/4 mg/L, cefepime/taniborbactam inhibited most tested species of GNB pathogens, with overall 98.9% susceptibility, which was significantly (P < 0.0001) higher than the susceptibility of the GNB isolates to all other tested comparator agents, ranging from 39.6% for cefepime to 86.3% for ceftazidime/avibactam. Our results showed that taniborbactam in combination with cefepime improved in vitro activity against GNB pathogens isolated from patients with cancer, including MDR Pseudomonas aeruginosa, carbapenem-resistant Enterobacterales, ESBL-producing Enterobacterales and Stenotrophomonas maltophilia isolates, with highest activity compared with all tested comparator agents, including other β-lactam/β-lactamase inhibitor combinations. Further studies are warranted to explore the efficacy of cefepime/taniborbactam for empirical initial treatment of GNB infections in cancer patients with high rates of febrile neutropenia requiring hospitalization.

Diagnostic accuracy of procalcitonin in adult non-neutropenic cancer patients with suspected infection: a systematic review and meta-analysis

BackgroundProcalcitonin (PCT) has garnered attention as a potential diagnostic biomarker for infection in cancer patients. We performed a systematic review and meta-analysis to evaluate the diagnostic accuracy of procalcitonin (PCT) and to compare it with C‐reactive protein (CRP) in adult non-neutropenic cancer patients with suspected infection.MethodsA systematic literature search was performed in MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials to identify all relevant diagnostic accuracy studies. Original articles reporting the diagnostic accuracy of PCT for infection detection in adult patients with solid or hematological malignancies were included. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, area under the hierarchical summary receiver operator characteristic (HSROC) curve, and corresponding 95% confidence interval (CI) were calculated.ResultsSeven studies were included in the meta-analysis. The pooled sensitivity and specificity of PCT were 60% (95% CI [45–74%]) and 78% (95% CI [69–86%]). The diagnostic odds ratio was estimated at 5.47 (95% CI [2.86–10.46]). Three studies compared the diagnostic accuracies of PCT and CRP. The pooled sensitivity and specificity values for PCT were 57% (95% CI [26–83%]) and 75% (95% CI [68–82%]), and those for CRP were 67% (95% CI [35–88%]) and 73% (95% CI [69–77%]). The pooled sensitivity and specificity of PCT and CRP did not differ significantly (p = 0.61 and p = 0.63). The diagnostic accuracy of PCT was similar to that of CRP as measured by the area under the HSROC curve (0.73, CI = 0.61–0.91 vs. 0.74, CI = 0.61–0.95, p = 0.93).ConclusionWhile elevated PCT levels can be indicative of potential infection, they should not be solely relied upon to exclude infection. We recommend not using the PCT test in isolation; Instead, it should be carefully interpreted in the context of clinical findings.

Comorbid pathology in SARS-CoV-2 infected in cancer practice as a predictor of severe outcomes in COVID-19. COVID-19 prognostic online risk assessment tool in oncology: A retrospective study

Aim. Evaluation of comorbid pathology in SARS-CoV-2 infected in cancer practice as a predictor of severe outcomes. Testing the COVID-19 risk assessment tool in oncology (CORONET), to predict the likely severity of COVID-19 course in cancer patients on inpatient treatment.&#x0D; Materials and methods. A retrospective analysis of 173 cancer patient disease stories was conducted. The study was conducted as part of the program of the World-Class Research Center “Digital Biodesine and Personalized Health Care” of the University of Sechenov, with participation in the ESMO-CoCARE Register project. Based on the ESMO COVID-19 and CAncerREgistry (ESMO-CoCARE) registry, taking into account the entered our patient sample (n=173), a COVID-19 risk assessment tool in oncology (CORONET) was developed.&#x0D; Results. Cancer patients with comorbid pathology have been shown to have an increased risk of COVID-19 course of the disease from this sample by CORONET (mean conclusion score CORONET 2.44 pointsseverity). Prognosis of probable severity of outcomes in cancer patients infected with SARS-CoV-2 depends on associated diseases. The presence of a history of ≥3 comorbid pathologies in COVID-19 patients was detected in 106 people (61.27%). 15 patients were included in the risk of severe course. Retrospective analysis obtained actual confirmation of the prognosis of severe course of the disease in this group followed by death in all these patients (71.42% of all deaths). Indicators such as low albumin levels, high levels of C-reactive protein and neutrophils showed high prognostic significance of the likely severity of coronavirus infection in cancer patients on inpatient treatment for COVID-19. The mortality rate of patients admitted with COVID-19 and cancer was 12.14%.&#x0D; Conclusion. The most informative predictors of severe outcomes in COVID-19 in inpatient cancer patients to assess the prognosis of disease severity are: number of comorbidities, age, NEWS2 scale, ECOG patient activity status, albumin level, C-reactive protein level and absolute neutrophil level. The benefits gained in the use of the online decision support tool CORONET are considered convincing not only during the decision-making phase of hospitalization, but also in cancer patients on inpatient treatment.

A novel cabazitaxel liposomes modified with ginsenoside Rk1 for cancer targeted therapy

Objective: In this study, we aim to enhance the anti-prostate cancer efficacy of cabazitaxel (CTX) and reduce its immunosuppression and systemic toxicity by developing CTX-loaded liposomes modified with ginsenoside Rk1 (Rk1/CTX-Lip). Methods: Physical and chemical properties of Rk1/CTX-Lip were investigated. We evaluated the biological functions of Rk1/CTX-Lip, both in vitro and in vivo. A subcutaneous prostate cancer (RM-1)-bearing mouse model was established to study the efficacy of Rk1/CTX-Lip inhibition in tumors. Simultaneously, a Candida albicans infection model was established in tumor-bearing mice to study the infection-relieving efficacy of Rk1/CTX-Lip. Finally, biocompatibility and in vivo safety of Rk1/CTX-Lip were evaluated. Results: We successfully prepared Rk1/CTX-Lip, achieving high CTX encapsulation efficiency (97.24 ± 0.75)% and physical stability. Rk1/CTX-Lip demonstrated evasion of macrophage phagocytosis, effective tumor tissue targeting, and a significant reduction (&gt;50%) in average tumor volume compared with Chol/CTX-Lip. Moreover, it relieved the concurrent infection burden and effectively regulated immune organs and cells, demonstrating superior biocompatibility. Conclusion: Rk1/CTX-Lip presents a promising new therapy for prostate cancer and holds potential for relieving concurrent fungal infections in cancer patients with low immunity.

Antibiotic susceptibility and virulence factors of bacterial species among cancer patients

Antibiotic resistance is one of the most significant challenges of the 20-s century, and the misuse of antibiotics is a driver of antimicrobial resistance. This study aimed to assess the prevalence of multidrug resistance, and detection of its produce virulence factors, including extended-spectrum β-lactamases (ESβLs), biofilm, and siderophores produced by bacterial species isolated from cancer patients. One hundred and seventy-five Gram-negative bacterial isolates were isolated from different samples collected from cancer patients admitted to the National Cancer Institute (NCI), Cairo, Egypt, and processed by standard microbiological methods. One hundred and forty-three bacterial isolates were recovered from adult patients, and 32 were recovered from children. Escherichia coli showed the highest frequency (36%), followed by Klebsiella pneumonia (30.85%), Acinetobacter baummannii (14.28%), and Pseudomonas sp. (9.14%). Antibiotic profiles revealed that bacterial isolates are highly resistant to the most commonly available antibiotics. Amikacin and gentamicin were the most effective antibiotics against isolated Gram-negative bacteria. Moreover, the vast majority of bacterial stains produce virulence factors, including EsβLs, biofilm, and siderophores. E. coli isolates produced ESβLs with rates of 25.28%, Klebsiella pneumonia (11.0%), and Pseudomonas sp. (25.0%). Among these collected bacterial isolates, 132 (75.4%) have the ability to form a biofilm to different degrees. Also, the majority of the bacteria isolates generated siderophores, with 133 (75.94%). This study revealed that a significant distribution of multidrug-resistant pathogenic bacteria may increase the burden on healthcare to prevent infections in cancer patients.

Characterizing skin and soft tissue infections in patients with cancer on systemic oncologic therapy: A single institution retrospective analysis from the outpatient and inpatient oncodermatology service

Characterizing skin and soft tissue infections in patients with cancer on systemic oncologic therapy: A single institution retrospective analysis from the outpatient and inpatient oncodermatology service

The Clinical Performance of Cell Population Data for Diagnosis of Bloodstream Infection in Cancer Patients.

Background Bloodstream infection (BSI) induces a change in the number and morphology of blood cells. In this study, we compared cell population data (CPD) parameters between cancer patients with or without BSI to determine whether these parameters could serve as biomarkers of BSI. Methods Between April and June 2021, 43 BSI-negative and 22 BSI-positive cancer patients were enrolled in this study. We compared 18 CPD parameters and biomarkers between cancer patients with BSI-positive and BSI-negative. Results There were significant differences in the levels of several CPD parameters, including MO-WZ (p=0.040), MO-X (p<0.01), MO-Y (p=0.012), NE-SFL (p<0.01), and NE-WX (p=0.037), but not C-reactive protein (p=0.347) and procalcitonin (p=0.237) between BSI-positive and BSI-negative patients. The areas under the receiver-operating characteristic curves (AUCs) were above 0.7 for MO-X (0.762; 95% confidence intervals (CI): 0.624-0.901), NE-SFL (0.766; 95% CI: 0.625-0.880). And LY-WY (p=0.024) showed a significant difference between gram-negative and gram-positive BSI patients with high AUC (0.883; 95% CI: 0.703-1). Conclusion CPD parameters (MO-Xand NE-SFL) provide additional information for discriminating between BSI-negative and BSI-positive BSI. And LY-WY provides useful information for discriminating between cancer patients with gram-negative BSI and gram-positive BSI.

Developing novel antimicrobials by combining cancer chemotherapeutics with bacterial DNA repair inhibitors.

Cancer chemotherapeutics kill rapidly dividing cells, which includes cells of the immune system. The resulting neutropenia predisposes patients to infection, which delays treatment and is a major cause of morbidity and mortality. To tackle this problem, we have isolated several compounds that inhibit bacterial DNA repair, alone they are non-toxic, however in combination with DNA damaging anti-cancer drugs, they prevent bacterial growth. These compounds were identified through screening of an FDA-approved drug library in the presence of the anti-cancer compound cisplatin. Using a series of triage tests, the screen was reduced to a handful of drugs that were tested for specific activity against bacterial nucleotide excision DNA repair (NER). Five compounds emerged, of which three possess promising antimicrobial properties including cell penetrance, and the ability to block replication in a multi-drug resistant clinically relevant E. coli strain. This study suggests that targeting NER could offer a new therapeutic approach tailor-made for infections in cancer patients, by combining cancer chemotherapy with an adjuvant that targets DNA repair.

Predictors of central line-associated bloodstream infections in cancer patients undergoing chemotherapy through implanted venous access ports: a retrospective, observational study.

Central venous catheters (CVCs) are sometimes superior to peripheral vascular access for chemotherapy. Central line-associated bloodstream infections (CLABSIs) are an important complication of CVCs in chemotherapy. A retrospective, observational study was conducted to investigate patients with implanted venous access ports (PORTs) from July 2010 to June 2021 in a teaching hospital. General conditions of the PORTs, backgrounds, and characteristics of patients were compared between CLABSI cases and uninfected cases to identify predictors of CLABSI. A total of 566 patients with PORTs who underwent chemotherapy were enrolled in this study, with CLABSI identified in 41 patients, for a total of 436,597 catheter-days. The median duration of PORT use was 26 vs. 494 days (P<0.001) in the CLABSI and uninfected groups, respectively. There were no significant differences in tumor classification, staging, white blood cell (WBC) count, neutrophil proportion, lymphocyte proportion, albumin, C-reactive protein (CRP), and performance status between the CLABSI and uninfected groups. Multivariable analysis showed that antibiotic usage within the previous week, total protein (TP), and immediate PORT use were independently associated with CLABSI, and their odds ratios (ORs) were 4.89 [95% confidence interval (CI): 1.67, 14.35], 1.95 (95% CI: 1.14, 3.53), and 3.13 (95% CI: 1.18, 8.30), respectively. The area under the curve (AUC) of the receiver-operating characteristic curve for TP was 0.63, and the cutoff value was 5.9 g/dL. PORT implantation should be avoided in patients who had antibiotic treatment episodes within 1 week, especially for those with low serum TP levels.

Prevalence and Disparities of Cardiovascular Events and Outcomes of COVID-19 Patients Hospitalized with Multiple Myeloma: A National Inpatient Sample Analysis, 2020

Background: Major adverse cardiovascular events and all-cause mortality are higher and well-known complications of COVID 19 infection in cancer patients. However, considering limited data comparing the trends and outcomes in COVID-19 patients with and without multiple myeloma (MM), this population-based study evaluates the epidemiological trends and characteristics of sex, race, and co-morbidities to further understand the outcomes in COVID-19 patients hospitalized with or without Multiple Myeloma (MM). Methods: The US National Inpatient Sample for 2020 was assessed in hospitalized patients using relevant ICD-10 CM diagnostic codes and a retrospective cohort study was conducted. The cohort consisted of COVID19 patients which were then divided into two categories based on the occurrence of MM. The impact of COVID19 in the prevalence and outcomes of cardiovascular events in patients with and without MM was evaluated using multivariable regression analysis to assess the independent predictors of all-cause mortality. Results: We identified 1,659,035 COVID-19-related admissions, of which, 5240 (0.3%) patients had MM and 1,653,795 without MM. A median age was found to be 65 years in both the cohorts. Cohort with MM often consisted of male (57.5% vs. 52%), black (29.8% vs. 19.9%), Medicare enrollee (72.3% vs. 53%), admissions at urban teaching hospital (76% vs. 71.5%), non-electively admitted patients (96.3% vs 95.4%) compared to cohort without MM. Hypertension (73.4% vs 64.7%), prior MI (5.3% vs. 4.2 %), prior Venous thromboembolism (10.9% vs. 4.2%), CKD (41.2% vs. 20.6%), prior cancer (11.3% vs. 7.5%), prior chemotherapy (9.2% vs. 0.8%), prior radiation (3.7% vs. 0.9%), Higher length of stay (6 vs. 5 days); higher cost ($60475.59 vs. $47794.25) were also noted more frequently in MM cohort with significant p-value of &amp;lt;0.05. Whereas the cohort without MM consisted of higher proportion of females (48% vs. 42.5%), white (53.2% vs. 52.3%), Hispanics (22.5% vs. 14.8%), Asian or Pacific islanders (3.4% vs. 2.8%), Native Americans (1.1% vs. 0.3%), patients from lower household income (34.1% vs. 30.7%), Medicaid enrollees (15.1% vs. 7.0%), and patients with diabetes (40% vs. 36.5%), hyperlipidemia (39.7% vs. 37%), obesity (26.4% vs. 18.9%), peripheral vascular disease (4% vs. 3.4%), alcohol abuse (2.4% vs. 0.5%). MM patients were at increased risk of death during COVID19 hospitalizations, with equal risk amongst Male (22.2%) and Female (22.0%), compared to those without MM (p &amp;lt; 0.001). MM patients of Hispanic race were at increased risk of mortality during COVID-19 hospitalization (30.1%) (p&amp;lt;0.001). Additionally, MM patients of both sexes were at increased risk of mortality during COVID-19 hospitalizations given history of atrial fibrillation, with increased risk in Male patients (26.7 %) compared to Female patients (19.8 %) (p &amp;lt;0.001). Amongst different races, MM patients with atrial fibrillation of Hispanic race had increased mortality on COVID-19 hospitalizations (17.1%) compared to non-MM Hispanic patients (7.7%) (p &amp;lt;0.001). The MM group exhibited higher percentages of all-cause mortality (22.1% vs. 13.4%), acute myocardial infarction (5.6% vs. 4.5 %), atrial fibrillation (23.8% vs. 15.5%), heart failure with preserved ejection fraction (10.7% vs. 6.6%), heart failure with reduced ejection fraction (5.3% vs. 4.1%), and acute ischemic stroke (1.8% vs. 1.3%) without any significant difference for cardiac arrest. However, on multivariable regression analysis adjusted for covariates, there was no difference between all-cause mortality in COVID19 patients with MM vs. without MM (p = 0.230). Conclusions: Multiple Myeloma in COVID19 is associated with higher cardiovascular events and death during hospitalization, however, the study failed to show a statistically significant difference when adjusted for potential confounders. Prevailing sex and race-based disparities in cardiovascular outcomes in COVID19 patients with MM warrant future longitudinal studies. Clinical Implications: Clinicians can use this data to identify MM patients with COVID-19 to implement appropriate management strategies to reduce the adverse outcomes. Given the long-term complications and progression of MM, it remains crucial to understand the relationship and systemic effects of COVID-19 on patients with MM and impact of different risk factors and co-morbidities on long-term outcomes in post-COVID phase.

Etiological factors of bloodstream infections in oncological patients, who was hospitalized at the National Institute of Maria Skłodowska-Curie - National Research Institute in Warsaw in 2020-2022.

The purpose of the study was the microbiological analysis of bloodstream infections in patients hospitalized at the National Institute of Oncology, Maria Skłodowska-Curie - National Research Institute in the period from 01/01/2020 to 31/10/2022. In the period from 01/01/2020 to 31/10/2022, 18,420 blood cultures obtained from patients hospitalized at the NIO-PIB were analysed in the Department of Clinical Microbiology (total for the presence of bacteria and fungi). Culture for the presence of bacteria was carried out in the BactAlert automatic system by bioMerieux, and for fungi in the Bactec FX automatic system by Becton Dickinson. 1,184 strains of bacteria and 32 strains of fungi considered to be the etiological factor of the infection were cultured from clinical samples. Gram-positive bacteria accounted for 61.57%, while Gram-negative bacteria accounted for 32.26% of all isolated bacterial strains. The most frequently cultured strains were Escherichia coli - 13.77% (including 22.1% of ESBL strains), Klebsiella penumoniae - 4.6% (44.4% of ESBL strains, 1.85% of NDM strains), Enterobacter cloacae - 2 .7% (including 40.6% of multi-resistant strains: ESBL (15.6%) or with AmpC derepression (25%), among the non-fermenting bacilli, Pseudomonas aeruginosa was the most frequently cultured - 4.18% (including 3.8% MBL) and Acinetobacter baumannii - 0.8% (including CRAB strains 50%, MBL 10%). Anaerobic microorganisms were responsible for 3.46% of blood infection cases. Yeast- like fungi were a factor in 2.7% of all fungemia cases. From blood samples taken Staphylococci were more frequently isolated directly from a vein or through a central venous catheter than aerobic Gram-negative bacilli (44.7% and 25.3% and 55.6% and 12.5%, respectively). The opposite situation occurred in the case of samples taken simultaneously directly from vein and through a central venous catheter, in which a higher share of aerobic Gram-negative bacilli (46.6%) than staphylococci (32.8%) in causing blood infections was observed. Gram-positive bacteria are the major contributors to bloodstream infections in cancer patients. There is a growing tendency to develop BSI caused by multi-resistant strains.

The impact of increasing non-albicans Candida trends on diagnostics in immunocompromised patients

Invasive candidiasis (IC) represents a growing concern worldwide, with a considerable increase in non-albicans Candida (NAC) species. The study's primary goal was to determine if species identification by semi-nested PCR (sn-PCR) with primers for the five most prevalent Candida species is sufficient to deal with the current trends of Candida infections in cancer patients. Over one year, Candida isolates were collected from samples of patients with hematological and solid organ tumors in a single center. Species of Candida were identified by chromagar and multiplex sn-PCR using specific primers for Candida albicans, Candida tropicalis, Candida glabrata, Candida krusei, and the Candida parapsilosis complex. Most Candida infection episodes are caused by NAC species (70.5% of 105 isolates). Rare species (14 isolates) accounted for 13.3% of isolates and were not identified by sn-PCR using the five most common Candida species primers. More than half of these rare species caused candidemia in cancer patients (57.1%; p = 0.011). The risk factor for candidiasis was recent surgeries (p = 0.020) in adults and chemotherapy in pediatric patients (p = 0.006). Prolonged hospitalization and genitourinary tract cancer were significantly associated with invasive infections (p = 0.005 and 0.049, respectively). Recent surgery was a significant risk factor associated with C. parapsilosis and C. glabrata infections (P = 0.038 and 0.003, respectively), while C. tropicalis was significantly more common in patients with hematological malignancies (P = 0.012). Techniques with a broader identification spectrum than the major five Candida species are crucial for the optimal management of cancer patients.

Retrospective Investigation of Antibiotic resistance pattern by Microbial pathogens isolated in surgical site infections in cancer patients

Retrospective Investigation of Antibiotic resistance pattern by Microbial pathogens isolated in surgical site infections in cancer patients

An Observational Study of Risk Factors for SARS-CoV 2 Infection in Patients with Cancer

Introduction: Cancer patients are regarded as a highly vulnerable population in Coronavirus Disease 2019 (COVID-19) pandemic due to their systemic immunosuppressive state. The aim of the study was to investigate the prevalence of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection in asymptomatic cancer patients attending the oncology clinic. Methods: We conducted a retrospective observational study from May- November 2020. The patients who tested positive for SARS-CoV-2 RT PCR were followed up to study the risk factors, clinical presentation, and outcome. The ethical approval from institutional review board was done. Chi-square test was used to compare qualitative variables and logistic regression model was used to estimate the odds ratio (OR) of having COVID-19 infection. Results: We included 334 cancer patients who were tested for COVID-19 infection. The prevalence of SARS-CoV-2 infection was 28.4%. COVID-19 infection was more common in solid organ malignancy than hematological cancer (29.2% vs. 26.1%). The risk of COVID-19 infection was associated with comorbidity (p = 0.002). Time since diagnosis of malignancy and the type of anticancer treatment received did not increase the risk of COVID-19 infection. However, patients receiving anticancer therapy in the last 4 weeks of testing positive for SARS-CoV-2 RT PCR had a higher risk for COVID-19 infection (p&lt;0001). The oncological treatment was continued after resolution of symptoms and with negative RT-PCR. The multi variable regression model revealed that females, patients having both hypertension and diabetes mellitus and patients receiving chemotherapy within the last 4 weeks had higher odds of COVID-19 infection (p&lt;0.05). Conclusion: We observed that active oncologic treatment does not represent a risk factor for SARS-CoV-2 infection in cancer patients. However delaying anticancer treatment to avoid SARS-CoV-2 transmission may lead to malignancy related complications. The approach of routine COVID 19 testing in cancer patients seems preferable in detecting asymptomatic virus carriers.