TY - JOUR T1 - Evaluation of Enterobacterales bloodstream infections in hematologic cancer patients TT - Hematolojik kanser hastalarında Enterobacterales kan dolaşımı enfeksiyonlarının değerlendirilmesi AU - Tavukcu, Esra AU - Arslan, Ferzan AU - Suzuk, Serap AU - Güreser, Ayşe AU - Mumcuoğlu, İpek AU - Inan, Nese AU - Ulaş, Turgay AU - Dal, Tuba PY - 2025 DA - January Y2 - 2024 DO - 10.31362/patd.1513010 JF - Pamukkale Medical Journal JO - Pam Tıp Derg PB - Pamukkale Üniversitesi WT - DergiPark SN - 1308-0865 SP - 207 EP - 217 VL - 18 IS - 1 LA - en AB - Purpose: In this study, we aimed to evaluate the clinical and laboratory findings of hospitalized patients withEnterobacterales bacteremia/sepsis, the risk factors for mortality and the therapeutic options for treatingbloodstream infections (BSIs) caused by Enterobacterales.Materials and methods: Patients hospitalized in the Oncology Hospital between January 2021 and December2022 whose Enterobacterales species were isolated in blood cultures were included in the study. Blood cultureswere incubated in the Autobio BC120 device. Isolated microorganisms were named using a Vitek-2 (bioMerieux,France) automated system. Antibiotic susceptibility tests were performed in the Vitek-2 system (bioMerieux,France) and the disc diffusion method. In addition, the demographic and laboratory data of the patients wereevaluated. A total of 103 patients were included in the study during the two years. Only the first isolates fromeach patient were included in the study.Results: The distribution of Enterobacterales isolates grown in blood cultures, in order of frequency wereEscherichia coli (n:74, 63.25%), Klebsiella pneumoniae ssp pneumoniae (n:27, 23.1%), Klebsiella pneumoniaessp ozaenae (n:2, 1.71%), Klebsiella oxytoca (n:1, 0.85%), Enterobacter cloaceae complex (n:10, 6.84%),Citrobacter freundii (n:1), Proteus mirabilis (n:1), Salmonella spp (n:1). The median (min-max) white blood cellcount was 1.51x103cells/uL (0.01-19.87), C-reactive protein (CRP) was 112.3 mg/L (0.06-546.0), procalcitoninwas 7.35 μg/L (0.05-61.21), time between blood culture collection and growing signal was 11.33 (3-58) hoursand the blood culture result report was three (1-8) days. Acute Myeloid Leukemia 40 (39.2%), B-cell AcuteLymphoblastic leukemia 18 (17.6%), Multiple Myeloma 11 (10.8%), Diffuse Large B-cell Lymphoma 11 (10.8%)were the most common diseases seen in Enterobacterales isolated patients from blood cultures.Conclusion: Each hospital should conduct its evaluation and examine the patient profile to make the correctempirical antibiotic selection. It is crucial to develop a suitable algorithm for this purpose. KW - Enterobacterales KW - bloodstream infections KW - hematologic cancer patients N2 - Amaç: Bu çalışmada Enterobacterales bakteriyemisi/sepsisi nedeniyle hastaneye yatırılan hastaların klinikve laboratuvar bulgularını, mortalite için risk faktörlerini ve Enterobacterales'in neden olduğu kan dolaşımıenfeksiyonlarının (KDE) tedavisine yönelik tedavi seçeneklerini değerlendirmeyi amaçladık.Gereç ve yöntem: Çalışmaya Ocak 2021 ile Aralık 2022 tarihleri arasında Onkoloji Hastanesi'nde yatan ve kankültürlerinde Enterobacterales türlerine rastlanan hastalar dahil edildi. Kan kültürleri Autobio BC120 cihazındainkübe edildi. İzole edilen mikroorganizmalar Vitek-2 (bioMerieux, Fransa) otomatize sistem kullanılarakadlandırıldı. Antibiyotik duyarlılık testleri hem Vitek-2 sistemi (bioMerieux, Fransa) hem de disk difüzyonyöntemiyle yapıldı. Ayrıca, hastaların demografik ve laboratuvar verileri değerlendirildi. İki yıllık dönemde toplam103 hasta çalışmaya dahil edildi. Her hastadan sadece ilk izolatlar çalışmaya dahil edildi.Bulgular: Kan kültürlerinde üreyen Enterobacterales izolatlarının dağılımı sıklık sırasına göre; Escherichia coli(%63,25, n:74), Klebsiella pneumoniae ssp pneumoniae (%23,1, n:27), Klebsiella pneumoniae ssp ozaenae(%1,71, n:2), Klebsiella oxytoca (%0,85, n:1), Enterobacter cloaceae kompleks (%6,84, n:10), Citrobacterfreundii (n:1), Proteus mirabilis (n:1), Salmonella spp (n:1) şeklindeydi. Ortalama (minimum-maksimum) lökositsayısı 1,51x103 hücre/uL (0,01-19,87), C-reaktif protein (CRP) 112,3 mg/L (0,06-546,0), prokalsitonin 7,35 μg/L(0,05-61,21), kan kültürünün alınmasıyla üreme sinyali arasında geçen süre 11,33 (3-58) saat ve kan kültürüsonuç raporu üç (1-8) gün olarak belirlendi. 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