Ann Plast Surg. Ceftazidime was administered with tobramycin for an initial 35days, and 23.6% of the -lactam group and 19.4% of the combination group used an initial vancomycin combination (P=0.507). TB-affected cancer patients also have more atypical clinical signs and symptoms than non-cancer patients [29]. J Acquir Immune Defic Syndr. Cancer Epidemiol Biomark Prev. Palella FJ Jr, et al. A trend analysis was conducted to calculate the annual deaths of cancer caused by infectious diseases. Neoplastic complications of HIV infection. statement and Chemotherapy can also affect multiple neutrophil functions, including chemotaxis and phagocytosis, independent of the quantitative defect . 2005;39(3):2939. Several studies have proven that -lactam monotherapy is non-inferior to combination treatment [8,9,10, 26]. Article Lancet HIV. Provided by the Springer Nature SharedIt content-sharing initiative. (DOCX 15 kb). A retrospective cohort study was conducted to compare the effects of combination antibiotic regimens to those of -lactam monotherapy for the treatment of community-onset pneumonia in neutropenic cancer patients. Eur J Cancer Care (Engl). Cancer Treat Res. In fact, Kaposi sarcoma was the third most common type of cancer associated with infectious diseases according to the results of 13,046 patients affected, one of the most common types of cancers in HIV patients [45]. Ceftazidime was used more frequently in the -lactam group, while piperacillin-tazobactam was used more in the combination group. This study was based on publicly available data from the SEER database. Pardoll D. Cancer and the immune system: basic concepts and targets for intervention. The chances of survival are improving, but cancer continues to be the leading cause of death in the US, with around 608,570 deaths annually [3]. A significant difference was found in the survival between men and women (P<0.0001), different organisms, race, and marital status (P<0.0001). Adult (age18years) cancer patients who were diagnosed with community-onset neutropenic pneumonia during the study period were included in the analysis. The most common type of cancer associated with infectious diseases was prostate cancer. 1943 Dec 18;2(4328):779-80. doi: 10.1136/bmj.2.4328.779. Causes of death in adults with acute leukemia. We exclusively included chemotherapy-induced neutropenia in the present study, and underlying cancers included solid cancers, lymphoma, and multiple myeloma. Although 30-day and 90-day all-cause mortality were higher in the -lactam group than in the combination group before adjustment, this finding suggests that more patients in the -lactam group had confounding factors for poor prognosis, including lung cancer, longer duration of neutropenia, or bacteremia, than patients in the combination group. Chen Y, et al. [PMC free article] [Google Scholar] Cruickshank R. Problems in Control of Infectious Diseases. Treatment of community-onset pneumonia in neutropenic cancer patients: -lactam monotherapy versus combination antibiotic regimens, https://doi.org/10.1186/s41479-019-0061-1, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/. This study determined the incidence of death due to infectious diseases among cancer patients. Among various clinical presentations of febrile neutropenia, pneumonia is considered high-risk [2]. Eliakim-Raz N, Robenshtok E, Shefet D, Gafter-Gvili A, Vidal L, Paul M, et al. This study aimed to answer the question of whether combination therapy is necessary in patients with neutropenic pneumonia. The overall incidence from 1973 to 2014 showed an insignificant decrease (annual percentage change=0.3, 95% confidence interval [CI]=2.21.7, P=0.8). These changes in the immune system that regulate the bodys protective mechanisms increase the risk of infection. 2014;6(4):215586. There are several limitations to our study. CAS Patients who were re-admitted 7days after discharge were excluded because they were assumed to have hospital-acquired pneumonia. Borges AH, Dubrow R, Silverberg MJ. Writing review & editing: HS, JHK, KRP, JYK, JHL, GEP, SYC, CIK, NYL, DRC. Therefore, this study aimed to determine the incidence of infectious diseases as a cause of death among cancer patients and analyze the trends and risk factors associated with mortality. 2021;71(1):733. zdemir BC, Dotto G-P. However, we inevitably expanded the study period to obtain statistical significance in comparing the two groups. To verify the effect of combination therapy on all-cause mortality due to neutropenic pneumonia, we also performed a subgroup analysis controlling for -lactam antibiotics, specifically cefepime which made up the highest proportion among the various -lactams (63.0%). Using antimicrobial adjuvant therapy in cancer treatment: a review. To compare the two groups, the Pearson 2 test and Fishers exact test were used for categorical variables, and Students t-test and the Mann-Whitney U test for continuous variables. Virulence. Your US state privacy rights, Outcomes in critically ill cancer patients with septic shock of pulmonary origin. Pneumonia was considered to be of community-onset if it developed in the community or within 48h after hospital admission [17, 18]. Treatment of community-onset pneumonia in neutropenic cancer patients: -lactam monotherapy versus combination antibiotic regimens. Clin Microbiol Infect. Patients with non-Hodgkin's lymphoma (NHL) receiving rituximab-containing chemotherapy are at risk of developing respiratory complications, but comprehensive information on these complications and their impact on survival is lacking. We aimed to determine the incidence of infectious diseases as a cause of death among cancer patients and analyze the trends and risk factors associated with mortality. Data used in the analysis were acquired from the Surveillance, Epidemiology, and End Results (SEER) 17 Registry, which includes data on tumors diagnosed between 1973 and 2014 [30]. Provided by the Springer Nature SharedIt content-sharing initiative. Infectious diseases are a major cause of morbidity and mortality among cancer patients. From 2001 to 2012 and from 2012 to 2014, a significant decrease was noted in the number of cancer patients who died due to infectious diseases (Table 2). The combination group included patients who were treated with a combination of a -lactam and a macrolide or fluoroquinolone, and the -lactam group included patients who received -lactam therapy only. Survival after cancer diagnosis in persons with AIDS. 4) included patients with pneumonia and influenza, septicemia, syphilis, and tuberculosis aged<75.5years, with a median survival of 2370days. Pneumonia, Pneumocystis / mortality Pneumonia, Pneumocystis / pathology Pneumonia, Pneumocystis . The sample size calculation for the study resulted in a sample size of 134 patients who were to be in a 1:1 allocation ratio to achieve a power of 95%. 1-4 Significantly higher mortality rates are also observed in non . Cox proportional hazards model and survival decision tree model were performed. 2005;24(4):2419. All authors read and approved the final manuscript. 1981;47(1):20714. We also identified the risk factors associated with death due to infectious diseases among 151,440 patients. For septicemia, patients with hematologic tumors other than leukemia, lymphoma, plasma cell tumors, and mast cell tumors had the highest incidence of septicemia, estimated to be 51.89% per 100 patients (SIR=51.9, 95% CI=1.31289.16), followed by nerve sheath tumors (SIR=3.91, 95% CI=0.121.7), and mesothelial neoplasms (SIR=3.21, 95% CI=0.3911.60). Johansen HK, Jensen TG, Dessau RB, Lundgren B, Frimodt-Moller N. Antagonism between penicillin and erythromycin against Streptococcus pneumoniae in vitro and in vivo. Pneumonia can cause nearly 10% of hospital admissions among cancer patients, especially those with hematologic malignancies, who have a pneumonia risk exceeding 30% during treatment [17,18,19]. 2012;53(6):106876. Lancet. Variations in the care of HIV-infected adults in the United States: results from the HIV Cost and Services Utilization Study. Racial differences in cancer susceptibility and survival: more than the color of the skin? I would like to thank Sara from Tanta University for providing assistance in the statistical analysis. 1943 Apr 24; 1 (4294):497-500. Pneumonia is usually caused by bacterial or viral infection at the pulmonary parenchyma which constitutes a crucial risk for morbidity and mortality worldwide 1,2.Community-Acquired Pneumonia (CAP . Chapter 2011;61(2):678. Survival decision tree identifying the four groups with their respective predicted survival. The patients mean age was 66.33years; majority of them were male (62%). Empiric antibiotic coverage of atypical pathogens for community-acquired pneumonia in hospitalized adults. Pneumocystis jirovecii infection causes pneumonia (PJP . The mean age of the patients was 66.3years, and most of them were male. This study showed that the rate of atypical pathogens was low although not all patients were examined. You are going to email the following Effect of Chemotherapy on Pneumonia Mortality. Bmj. In reality, pneumonia is the primary cause of death in patients with acute leukemia during the transfusion period [20, 21]. Results of Cox proportional hazard regression analysis to identify the risk for mortality due to infectious diseases. Cite this article. The mortality rate of PJP pneumonia in patients with hematological malignancies is estimated between 30% and 60% and is likely slightly higher in HSCT patients . 2012;(9):Cd004418. The outcomes and complications of patients with neutropenic pneumonia are summarized in Table3. The risk of TB in this patient group is due to immunosuppression caused by chemotherapy and local anatomical alterations in the lungs caused by primary lung cancer or metastasis [26]. The most common infectious diseases were pneumonia and influenza. N Engl J Med. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. community-onset pneumonia with febrile neutropenia. Topics . Two models were used in the survival analysis: the Cox proportional hazards model and the survival decision trees model. Hughes WT, Armstrong D, Bodey GP, Bow EJ, Brown AE, Calandra T, et al. Causative pathogens of neutropenic pneumonia were identified in 27.9% of the patients, of which Streptococcus pneumoniae was the most common followed by Pseudomonas aeruginosa, Staphylococcus aureus, and Klebsiella pneumoniae (23.9, 19.6, 15.2, and 13.0%, respectively; Additional file 1: Table S1). Ann Hematol. 2019;98(5):105169. Seok, H., Ko, JH., Peck, K.R. Approximately 78% of the patients were widowed. 2007;59(4):46472. Pinzone MR, et al. 2000;18(16):303851. Antibiotic treatment strategies for community-acquired pneumonia in adults. Lymphedema in a cohort of breast carcinoma survivors 20 years after diagnosis. 2021;7(2):2207. The most common type of cancer associated with infectious diseases was prostate cancer (n=20,068), followed by breast cancer (n=16,676), and Kaposi sarcoma (n=13,046). 2007;44(Suppl 2):S2772. The immune system in cancer pathogenesis: potential therapeutic approaches. Retrospectively collected data included demographics, underlying diseases, clinical presentations and outcomes, laboratory test results, types and duration of antibiotic therapy, and microbiologic data. Clin Med (Lond). CAS Siegel RL, et al. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Due to the extended study period of 20years, there were considerable differences in the types of -lactams between the two groups. & Msherghi, A. Percent of adults aged 18 and over who had ever received a pneumococcal vaccination: 23.9% (2022) Source: Interactive Summary Health Statistics for Adults: National Health Interview Survey, 2019-2022. Part of Kyong Ran Peck. Aspiration pneumonia is one of the most important side effects of chemoradiotherapy (CRT) and bio-radiotherapy (BRT) in patients with head and neck cancer (HNC). The second comprised patients aged>75.5years with a median survival of 1290 (red in Fig. 2017;31(14):190316. In the present study, the 28-day pneumonia-related mortality rate of patients categorized by CURB-65 scores <2 or low risk, . In most cases, the earliest and only symptom of infection can be neutropenic fever [25]. In addition, cancer patients are more likely to be colonized with multi-drug resistant organisms with exposure to antibiotics. Therefore, cancer patients are vulnerable to infection. Antimicrob Agents Chemother. Between 30 and 40% of HIV-infected patients are susceptible to developing any cancer type [44]. Google Scholar. Cookies policy. CAS New immunosuppressive therapies produce a variety of immune vulnerabilities that form the basis of opportunistic infections. Clin Chest Med. Millward MJ, et al. Cancer statistics, 2021. Selection of antibiotics should be based . Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, et al. admission and mechanical ventilation, compared with HIV-infected patients. Data analysis: HS, JHK, KRP, SYC, CIK. Viruses. Addition of a macrolide to a ss-lactam in bacteremic pneumococcal pneumonia. 2012;7(1):3333. volume16, Articlenumber:72 (2021) Basal cell neoplasms had the highest significant risk of mortality from infections (HR=1.33, SE=0.14, P=0.04) (Additional file 3: Table 1). The rate of febrile neutropenic-related mortality is up to 11%; in the case of severe sepsis, it can reach 50% [25]. A retrospective cohort study was conducted to compare the effects of combination antibiotic regimens to those of -lactam monotherapy in cancer patients with community-onset neutropenic pneumonia. The nomogram was calibrated for 1, 3, and 5years by comparing the predicted survival with the observed survival. 2014;3(4):96270. Therefore, early risk assessment and comprehensive evaluation are needed to define febrile patients at risk of severe infection and provide early prophylaxis, which can substantially reduce mortality and morbidity associated with infection and breast cancer patients. Global estimates of HIV infections and AIDSearly 1992. A cancer patients susceptibility to pneumonia arises from the overall consequences of illness, chemotherapy, and overall immune dysfunction, making them susceptible to pathogen exposure [16]. There are several reasons for the higher infectious disease-related mortality among breast cancer patients. Trend analysis of cancer patients who died because of infectious diseases. Although -lactam monotherapy may be sufficient in non-critically ill patients with community-acquired pneumonia, the value of combination antibiotic regimens in community-onset neutropenic pneumonia remains unclear. Pneumonia was defined as the presence of parenchymal infiltration on chest radiography (newly appeared infiltration or aggravation of preexisting lesions) with relevant respiratory symptoms, including cough, sputum production, shortness of breath, or pleuritic chest pain [17]. Cancer patients who undergo cytotoxic therapy are at risk for developing infections attributable to the colonizing bacteria or fungi translocating through the mucosal surfaces. Ray WA, Murray KT, Hall K, Arbogast PG, Stein CM. Pneumonia is the most common cause. Cookies policy. 2020;68(5):100714. We performed the proportional hazards assumption of Cox regression to ensure that the assumption is satisfied. An improved overall survival was noted in the pembrolizumab and chemotherapy group with a median OS of 23.0 months (95% CI 19.0-26.3) compared to chemotherapy alone (15.5 months [95% CI 13.9-17.2]), validating results reported in the prior interim analysis of Keynote-355 . Flores IQ, Ershler W. Managing neutropenia in older patients with cancer receiving chemotherapy in a community setting. Human viruses and cancer.

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