RISK-FACTORS AND ATTRIBUTABLE MORTALITY ASSOCIATED WITH SUPERINFECTIONS IN NEUTROPENIC PATIENTS WITH CANCER

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.