M. Nucci et al., RISK-FACTORS AND ATTRIBUTABLE MORTALITY ASSOCIATED WITH SUPERINFECTIONS IN NEUTROPENIC PATIENTS WITH CANCER, Clinical infectious diseases, 24(4), 1997, pp. 575-579
To identify the risk factors and attributable mortality associated wit
h superinfections in febrile neutropenic patients with hematologic mal
ignancies, we prospectively evaluated 333 episodes of fever and neutro
penia by means of univariate and multivariate analyses. Superinfection
was defined as any infection either occurring during antibiotic thera
py or developing within 1 week after discontinuation of antibiotic the
rapy, Of 333 episodes, 46 (13.8%) were defined as superinfection; thes
e episodes occurred in 46 patients. The risk factors for superinfectio
n in the multivariate analysis were longer duration of profound neutro
penia (P < .0001), lack of use of quinolones as prophylaxis (P < .0001
), presence of a central venous catheter (P = .02), and persistence of
fever after 3 days of antibiotic therapy (P = .02), The crude mortali
ty rate among patients with superinfection was 48%, and the attributab
le mortality rate was 24% (95% confidence interval, 3%-45%). Identifyi
ng risk factors for superinfections in neutropenic patients might allo
w clinical practices to reduce the negative impact of this complicatio
n.