1018. Prevalence of bacteremia/fungemia and pneumonia in remission induction chemotherapy for adult acute myeloid leukemia from 1987 to 2005: Japan Adult Leukemia Study Group (JALSG).
Session: Poster Abstract Session: Bacteremia and Endocarditis
Friday, October 5, 2018
Room: S Poster Hall
Posters
  • IDweek2018_poster1018_Kato_JALSG.pdf (2.1 MB)
  • Background: Remission induction (RI) chemotherapy for acute myeloid leukemia (AML) is one of the most intensive chemotherapy available. Antibiotic prophylaxis and prompt treatment for infectious complications during RI chemotherapy plays a major role in supportive care.

    Methods: We retrospectively analyzed the infectious complications associated with RI chemotherapy listed in the Japan Adult Leukemia Study Group AML201 protocol, a nationwide study of de-novo AMLs, conducted between 2001 and 2005 in Japan. Of the 1057 cases initially included in the AML201 study, 980 cases with data on infectious complications during RI chemotherapy were analyzed. The incidences of infectious complications and the causative pathogens were compared with previous studies [(period A) 1987–1991, 577 cases; (B) 1992–1995, 669 cases; (C) 1995–1997, 531 cases; (D) 1997–2001, 808 cases; (E) 2001–2005, 980 cases].

    Results: In study period E, the causative pathogens of bacteremia/fungemia were Staphylococcus epidermidis (20.9%), S. aureus (11.6%), Streptococcus sp. (14.0%), and other Gram-positive bacteria (18.6%); P. aeruginosa(12.8%) and other Gram-negative bacteria (10.5%); and fungi (9.3%). Pathogens causing pulmonary infections were Aspergillus sp.(15.8%), P. aeruginosa (7.9%), and other Gram-negative bacteria (6.9%) and Gram-positive bacteria (3.0%). Pulmonary aspergillosis was diagnosed mainly using serological test. The prevalence of bacteremia/fungemia was reported in 11.8%, 9.4%, 8.7%, 9.2% and 8.3% of cases and pulmonary infections were reported in 24.6%, 16.9%, 13.9%, 12.9%, and 10.3% of cases in the study periods A, B, C, D and E, respectively. The incidence of Gram-negative bacteremia was significantly lower in period E compared with the periods A, B, and C (2.0% vs. 4.9%, 3.7%, and 3.4%, respectively).

    Conclusion: The prevalence of Gram-positive bacteremia and pulmonary aspergillosis was higher in period E than in the periods A–D. This trend was possibly due tothe wide use of fluoroquinolone prophylaxis in neutropenic patients and high performance of the serological test for aspergillosis. Sufficient monitoring for Gram-positive bacterial infection and mold infection is therefore essential during RI chemotherapy for AML.

    Hideaki Kato, MD, Dept. of Hematology and Clinical Immunology, Yokohama City Univ. School of Medicine, Yokohama, Japan, Hiroyuki Fujita, MD, Department of Hematology, Saiseikai Yokohama Nanbu Hospital, Yokohama, Japan, Nobu Akiyama, MD, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan, Shun-Ichi Kimura, MD, Division of Hematology, Saitama Medical Center, Jichi Medical Univ., Saitama, Japan, Nobuhiro Hiramoto, MD, Dept. of Hematology, Kobe City Medical Center General Hosp., Kobe, Japan, Naoko Hosono, MD, Dept. of Hematology and Oncology, Univ. of Fukui, Eiheiji-cho, Japan, Tsutomu Takahashi, MD, Dept. of Oncology/Hematology, Shimane Univ. Hosp., Izumo, Japan, Kazuyuki Shigeno, MD, Dept. of Hematology and Oncology, Hamamatsu Medical Center, Hamamatsu, Japan, Hitoshi Minamiguchi, MD, Dept. of Gastroenterology and Hematology, Shiga Univ. of Medical Science, Otsu, Japan, Junichi Miyatake, MD, Dept. of Hematology and Oncology, Sakai Hosp. Kinki Univ. Faculty of Medicine, Osaka-Sayama, Japan, Hiroshi Handa, MD, Dept. of Hematology and Oncology, Gunma Univ. Graduate School of Medicine, Maebashi, Japan, Yoshinobu Kanda, MD, Division of Hematology, Dept. of Medicine, Jichi Medical Univ., Tokyo, Japan, Minoru Yoshida, MD, Fourth Dept. of Internal Medicine, Teikyo Univ. School of Medicine, Mizonokuchi Hosp., Kawasaki, Japan, Shuichi Miyawaki, MD, Dept. of Transfusion, Tokyo Metropolitan Ohtsuka Hosp., Tokyo, Japan, Shigeki Ohtake, MD, Kanazawa Univ., Kanazawa, Japan, Tomoki Naoe, MD, National Hosp. Organization Nagoya Medical Center, Nagoya, Japan, Hitoshi Kiyoi, MD, Dept. of Hematology and Oncology, Nagoya Univ. Graduate School of Medicine, Nagoya, Japan, Itaru Matsumura, MD, Dept. of Hematology and Rheumatology, Kinki Univ. Faculty of Medicine, Osaka-Sayama, Japan and Yasushi Miyazaki, MD, Dept. of Hematology and Molecular Medicine Unit, Nagasaki Univ. Graduate School of Biomedical Sciences, Atomic Bomb Disease Institute, Nagasaki, Japan

    Disclosures:

    H. Kato, None

    H. Fujita, None

    N. Akiyama, None

    S. I. Kimura, None

    N. Hiramoto, None

    N. Hosono, None

    T. Takahashi, None

    K. Shigeno, None

    H. Minamiguchi, None

    J. Miyatake, None

    H. Handa, None

    Y. Kanda, None

    M. Yoshida, None

    S. Miyawaki, None

    S. Ohtake, None

    T. Naoe, None

    H. Kiyoi, None

    I. Matsumura, None

    Y. Miyazaki, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.