ID-IRI international study “Prospective Analysis of Febrile Neutropenia Patients with Bacteremia: The Results of ID-IRI Study” is accepted for publication in the International Journal of Antimicrobial Agents (IF-15.44). https://infectdisiri.com/id-iri-2023/  

The study pooled the data of febrile neutropenia patients with bacteremia in 41 cancer/referral centers in 16 countries and analyzed 431 patients. Due to the undefined thresholds for certain microorganisms in the laboratory documents (EUCAST, CLSI) for certain antimicrobials, most studies analyzed similar groups of patients infected with particular pathogens (FN patients with staphylococcal bacteremia or Gram-negative bacteremia, etc.). However, we overcame this dilemma with robust mathematical modeling and could enroll all types of bacteremias. In addition, we excluded

1.    Patients with polymicrobial growth in the blood cultures.

2.    Patients with blood culture positivity other than the initial isolate in the subsequent cultures within the 30 days

3.    Patients with fungal blood culture positivity and fungal infection

Hence, the study aimed to disclose the direct effects of bacteremia in principle. SINCERE CONGRATULATIONS TO THE TEAM FOR THE GREAT SUCCESS WE ACHIEVED TOGETHER and we would like to thank Prof. Daniel R. Lucey for the final editing of the paper.

In this study, initial treatment was appropriate in only 64% of the patients. It appears that hemato-oncology patients seem to have acquired excessively resistant microbes from the hospitals during their long-lasting chemotherapy adventures. In addition, WE COULD NOT SHOW that the fundamental factors facilitating the development of infection among neutropenic cancer patients contributed significantly to 30-day in-hospital mortality if bacteremia develops. The factors which DO NOT AFFECT MORTALITY in this subset of patients were:

·      The types of haemato-oncological malignity

·      Neutropenia duration

·      Deep neutropenia

·      Previous antimicrobial prophylaxis

·      HSCT type, if it was done

·      Underlying comorbid conditions including diabetes

·      Levels of inflammatory markers

·      Blood parameters (hemoglobin, platelet, ANC)

However, we found that clinical parameters directly related to bacteremia and its’ management INCREASED MORTALITY significantly. These are:

1.    Inappropriate antimicrobial treatment

2.    qSOFA score (2.857-fold for each unit increase)

3.    Pulse rate (1.018-fold for each increasing digit)

4.    Advancing age (1.017-fold rising risk yearly)

5.    Gram-negative bacteremia

6.    Bacteremia of non-urinary origin

For your information and best wishes

List of Authors

Hakan Erdem, Esra Kocoglu, Handan Ankarali, Rehab El-Sokkary, Atousa Hakamifard, Ridvan Karaali, Sholpan Kulzhanova, Amani El-Kholy, Hamed Azhdari Tehrani, Reham Khedr, Ayşe Kaya-Kalem, Nenad Pandak, Meliha Cagla-Sonmezer, Summiya Nizamuddin, Hande Berk-Cam, Rahmet Guner, Jehan Ali Elkholy, Ferran Llopis, Andrea Marino, Roman Stebel, Balint Gergely Szabo, Maya Belitova, Elias Fadel, Tarkan Yetisyigit, Yasemin Cag, Sevil Alkan, Bircan Kayaaslan, Serkan Oncu, Mehmet Ozdemir, Mesut Yilmaz, Arzu Cennet Isik, Dilşah Başkol, Gulden Sincan, Antonio Cascio, Safak Ozer-Balin, Nesibe Korkmaz, Rezaul Karim Ripon, Salma Abbas, Irina Magdalena Dumitru, Gulden Eser-Karlidag, Massimiliano Lanzafame, Abdur Rafey, Aun Raza, Oguz Resat Sipahi, Ilad Alavi Darazam, Umran Elbahr, Ilknur Erdem, Pinar Ergen, Cemil Bilir, Hulya Caskurlu, Aysegul Erdem, Mateja Jankovic Makek, Mustafa Altindis, Botond Lakatos, Catalina Mihaela Luca, Esmeray Mutlu Yilmaz, Emmanuel Nsutebu, Rumeysa Cakmak, Fatma Sirmatel