Table 1 Basic clinical characteristics of HMs patients with positive CR-GNB cultures in anal swab
Metrics
|
Non-infection (N=209)(%)
|
Infection (N=183)(%)
|
P
|
Total (%)
|
Gender
|
|
|
|
|
Male
|
133(63.6%)
|
113(61.7%)
|
0.7
|
246(62.8%)
|
Female
|
76(36.4%)
|
70(38.3%)
|
|
146(37.2%)
|
Age
|
|
|
|
|
<60
|
173(82.8%)
|
162(88.5%)
|
0.107
|
335(85.5%)
|
≥60
|
36(17.2%)
|
21(11.5%)
|
|
57(14.5%)
|
Primary disease
|
|
|
|
|
AML
|
118(56.5%)
|
98(53.6%)
|
0.347
|
216(55.1%)
|
ALL
|
31(14.8%)
|
38(20.8%)
|
|
69(17.6%)
|
Lymphoma
|
17(8.1%)
|
14(7.7%)
|
|
31(7.9%)
|
MDS
|
16(7.7%)
|
14(7.7%)
|
|
30(7.6%)
|
CML
|
13(6.2%)
|
4(2.1%)
|
|
17(4.4%)
|
MPAL
|
7(3.3%)
|
7(3.8%)
|
|
14(3.6%)
|
MM
|
3(1.5%)
|
1(0.5%)
|
|
4(1.0%)
|
Others
|
4(1.9%)
|
7(3.8%)
|
|
11(2.8%)
|
HSCT
|
|
|
|
|
YES
|
37(17.7%)
|
57(31.1%)
|
0.002
|
94(23.9%)
|
NO
|
172(82.3%)
|
126(68.9%)
|
|
298(76.1%)
|
Survival status
|
|
|
|
|
Survival
|
191(91.4%)
|
103(56.3%)
|
<0.001
|
294(75.0%)
|
Death
|
18(8.6%)
|
80(43.7%)
|
|
98(25.0%)
|
Note: HMs, hematological malignancies; AML, acute myeloblastic leukemia; ALL, acute lymphoblastic leukemia; MPAL, mixed phenotype acute leukemia; CML, chronic myeloblastic leukemia; MDS, myelodysplastic syndrome; MM, multiple myeloma; Others: myeloid sarcoma(6), myelofibrosis(3), hairy cell leukemia(2).
Table 2 Risk factors of Subsequent t Infection after CR-GNB Colonization in HMs patients
|
|
Univariate analysis
|
Multivariable analysis
|
Metrics
|
|
Group
|
P
|
P
|
OR
|
95%CI
|
Non-infection (N=209)
|
Infection (N=183)
|
HSCT
|
NO
|
172(57.7%)
|
126(42.3%)
|
0.002
|
|
|
|
YES
|
37(39.6%)
|
57(60.6%)
|
|
|
|
Mucositis
|
|
|
|
|
|
|
No
|
112(69.1%)
|
50(30.9%)
|
<0.001
|
<0.001
|
3.248
|
2.089-5.114
|
|
YES
|
97(42.2%)
|
133(57.8%)
|
|
|
|
|
Pneumonia
|
NO
|
4(50%)
|
4(50%)
|
0.849
|
|
|
|
|
YES
|
205(53.4%)
|
179(46.6%)
|
|
|
|
|
The duration of agranulocytosis
|
|
|
|
|
|
|
1-14
|
73(50.3%)
|
72(49.7%)
|
0.015
|
0.007
|
1.959
|
1.198-3.227
|
|
≥15
|
34(38.6%)
|
54(61.4%)
|
<0.001
|
<0.001
|
2.651
|
1.509-4.717
|
Hypoalbuminemia
|
|
|
|
|
|
|
NO
|
149(57.3%)
|
106(42.7%)
|
0.006
|
0.009
|
1.837
|
1.170-2.904
|
|
YES
|
60(43.8%)
|
77(56.2%)
|
|
|
|
|
Antimicrobial agents exposure
|
|
|
|
|
|
Cephalosporins
|
NO
|
56(50.5%)
|
55(49.5%)
|
0.475
|
|
|
|
|
YES
|
153(54.4%)
|
128(45.6%)
|
|
|
|
|
Aminoglycosides
|
NO
|
139(59.9%)
|
93(40.1%)
|
0.002
|
|
|
|
|
YES
|
70(43.8%)
|
90(56.2%)
|
|
|
|
|
Carbapenems
|
NO
|
95(60.1%)
|
63(39.9%)
|
0.026
|
|
|
|
|
YES
|
114(48.7%)
|
120(51.3%)
|
|
|
|
|
Quinolones
|
NO
|
137(54.2%)
|
116(45.8%)
|
0.655
|
|
|
|
|
YES
|
72(51.8%)
|
67(48.2%)
|
|
|
|
|
Special drugs exposure
|
|
|
|
|
Remission induction chemotherapy
|
|
|
|
|
|
NO
|
93(60.4%)
|
61(39.6%)
|
0.024
|
0.005
|
1.921
|
1.217-3.054
|
|
YES
|
116(48.7%)
|
122(51.3%)
|
|
|
|
|
Immunosuppressant
|
|
|
|
|
|
|
NO
|
179(56.8%)
|
136(43.2%)
|
0.005
|
|
|
|
|
YES
|
30(39%)
|
47(61%)
|
|
|
|
|
Glucocorticoid
|
|
|
|
|
|
|
NO
|
112(61.2%)
|
71(38.8%)
|
0.003
|
|
|
|
|
YES
|
97(46.4%)
|
112(53.6%)
|
|
|
|
|
PPIs
|
18(12,26)
|
22(14.75,28)
|
0.019
|
|
|
|
Invasive procedures
|
|
|
|
|
|
CVC
|
NO
|
58(67.4%)
|
28(32.6%)
|
0.003
|
|
|
|
|
YES
|
151(49.3%)
|
155(50.7%)
|
|
|
|
|
Mechanical ventilation
|
|
|
|
|
|
|
NO
|
195(54%)
|
166(46%)
|
0.345
|
|
|
|
|
YES
|
14(45.2%)
|
17(54.8%)
|
|
|
|
|
Others (sputum suction, catheterization)
|
|
|
|
|
NO
|
186(55.7%)
|
148(44.3%)
|
0.024
|
|
|
|
|
YES
|
23(39.7%)
|
35(60.3%)
|
|
|
|
|
Note: HMs, hematological malignancies; HSCT, hematopoietic stem cell transplantation; PPIs, proton pump inhibitors; CVC, central venous catheter.
Table 3 Predictive Scoring Table for Risk of Subsequent Infection after CR-GNB Colonization in HMs patients
Risk factors
|
Category
|
Regression coefficient βi
|
Score
|
Remission induction chemotherapy
|
1.921
|
|
|
NO
|
|
0
|
|
YES
|
|
1
|
The duration of agranulocytosis
|
|
|
|
0
|
|
0
|
|
1-14
|
1.959
|
1
|
|
≥15
|
2.651
|
2
|
Mucositis
|
|
3.248
|
|
|
NO
|
|
0
|
|
YES
|
|
2
|
Hypoalbuminemia
|
|
1.837
|
|
|
NO
|
|
0
|
|
YES
|
|
1
|
Table 4 Comparison of Incidence of Subsequent Infection after CR-GNB Colonization in Different Risk Stratification Groups
Infection Risk Stratification
|
Infection rate
|
P
|
OR (95%CI)
|
Low-risk (<3.5)
|
68(32.54%)
|
<0.001
|
3.347(2.218-5.094)
|
High-risk(≥3.5)
|
113(61.75%)
|