FEVER OF UNKNOWN ORIGIN AND MULTIDRUG-RESISTANT ORGANISMS COLONIZATION IN AML PATIENTS.

Main Article Content

Luca Guarnera
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

Gentiana Elena Trotta
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

Valentina Boldrini
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

Lucia Cardillo
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

Ilaria Cerroni
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

Valeria Mezzanotte
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

Gianmario Pasqualone
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

Arianna Savi
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

Beatrice Borsellino
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

Elisa Buzzatti
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

Raffaele Palmieri
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

Giovangiacinto Paterno
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

Luca Maurillo
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

Francesco Buccisano
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

Adriano Venditti
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

Maria Ilaria Del Principe
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

Keywords

Acute Myeloid leukemia, fever of unknown origin, Colonization, Multidrug-resistant organisms

Abstract

Abstract. Background: Colonization by multidrug-resistant organisms (MDRO) is a frequent complication in hematologic departments, which puts patients at risk of life-threatening bacterial sepsis. Fever of unknown origin (FUO) is a condition related to the delivery of chemotherapy in hematologic malignancies, in which the use of antibiotics is debated. The incidence, risk factors, and influence on the outcome of these conditions in patients with acute myeloid leukemia (AML) are not clearly defined.
Methods: We retrospectively analyzed 132 consecutive admissions of non-promyelocytic AML patients at the Hematology Unit of the University Tor Vergata in Rome between June 2019 and February 2022. MDRO swab-based screening was performed in all patients on the day of admission and once weekly after that. FUO was defined as fever with no evidence of infection.
Results: Of 132 consecutive hospitalizations (69 AML patients), MDRO colonization was observed in 35 cases (26%) and resulted independently related to a previous MDRO colonization (p=0.001) and length of hospitalization (p=0.03). The colonization persistence rate in subsequent admissions was 64%. MDRO-related bloodstream infection was observed in 8 patients (23%) and correlated with grade III/IV mucositis (p=0.008) and length of hospitalization (p=0.02). FUO occurred in 68 cases (51%) and correlated with an absolute neutrophilic count <500μ/L at admission (0.04).
Conclusion: In our experience, MDRO colonization is a frequent and difficult-to-eradicate condition that can arise at all stages of treatment. Prompt discharge of patients as soon as clinical conditions allow could limit the spread of MDRO. In addition, the appropriate use of antibiotics, especially in the case of FUO, and the contraction of hospitalization length, when feasible, are measures to tackle the further spread of MDRO.

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Published
Jan 1, 2023
DOI https://doi.org/10.4084/MJHID.2023.013

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How to Cite

Guarnera, L. (2023) “FEVER OF UNKNOWN ORIGIN AND MULTIDRUG-RESISTANT ORGANISMS COLONIZATION IN AML PATIENTS”., Mediterranean Journal of Hematology and Infectious Diseases, 15(1), p. e2023013. doi: 10.4084/MJHID.2023.013.
Issue
Vol. 15 No. 1 (2023): Review Articles, Original Article, Scientific Letter, Case Reports Letter to the Editor
Section
Original Articles
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