Blood Stream Infections (BSI) Survival in Black Patients with High Comorbidity Index
Michael Haddadin1, Josephine Anuforo2, Gwyneth Sultan1, Ellen Oseni1, Akeem Lewis1, Jianxiang Xia1, Iuliana Shapira1. 1SUNY Downstate Medical Center, Syosset, New York, United States, 2Medicine, St john's Episcopal Hospital, Far Rockaway, New York, United States
Purpose of Study Black patients with blood stream infections have far worse outcomes (30% lower overall survival) than white patients. Significant cancer health disparities exist in Blacks with blood stream infections. These patients have far worse outcomes (30% lower overall survival) than white patients. We seek to understand population specific disease manifestations and treatments. We analyzed retrospectively survival from blood stream infection in 236 consecutive patients diagnosed with blood stream infections. Type of infection, resistance to antibiotics and overall survival patients with high comorbidity burden and blood stream infection were analyzed
Methods Used Survival was defined as the time from positive blood culture to discharge. We did a retrospective review of consecutive BSI were evaluated as part of performance improvement process to detect trends of microorganism resistance and avoid using inappropriate treatments for infections. Two group of infected patients were analyzed those with central venous catheters, versus those without. Characteristics of patients in different groups were compared using Chi-square or Fisher's exact tests for categorical variables, and Wilcoxon rank-sum test for continuous variables. P ≤ 0.05 (two-tailed) considered statistically significant. A multivariable logistic regression model was constructed to identify baseline factors independently associated with one year mortality
Summary of Results A 50% better median OS (HR=0.67; 95% confidence interval 0.43-0.78) was seen in patients with BSI and no catheter compared to those with inserted catheters
Conclusions Black patients with advanced malignancies often have blood stream infections (BSI) and if this occurs in the hospital the infection is attributed to nosocomial intervention. Little is known and published about microorganism incubation times, epithelial barrier disruption, sepsis, systemic inflammatory symptoms definition in minority black population. Population specific studies of mechanisms explaining the immune anergy detected in patients with high comorbidities and BSI.
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