Oncologic status associated with higher 30-day mortality in multidrug-resistant bloodstream infections

In a retrospective cohort study at the Policlinico of Bari in southern Italy, patients with cancer who developed bloodstream infections caused by multidrug-resistant organisms had higher 30-day all-cause mortality than patients without cancer. The analysis, summarized in the study abstract, included 204 hospitalized patients: 145 classified as non-oncologic and 59 as oncologic, with the latter group comprising 30 patients with solid tumors and 29 with hematologic malignancies. Thirty-day mortality was 30.5% among oncologic patients and 11.7% among non-oncologic patients, a difference reported as statistically significant (p = 0.002).

The study examined patients hospitalized with multidrug-resistant organism bloodstream infections from 1 January 2021 through 30 January 2026. Investigators compared demographic, clinical, microbiological, molecular, treatment-exposure and outcome data between oncologic and non-oncologic groups. ICU admission at the onset of infection was more frequent among oncologic patients, occurring in 25.4% compared with 4.8% of non-oncologic patients (p < 0.001). The primary outcome was 30-day all-cause mortality, assessed using survival analysis and logistic regression.

Among the 204 infections, KPC-producing Enterobacterales were the leading resistance determinant, identified in 147 cases (72.1%). Multidrug-resistant or carbapenem-resistant Acinetobacter species accounted for 35 cases (17.2%), NDM-producing Enterobacterales for 14 (6.9%) and VIM-producing Enterobacterales for six (2.9%). Multidrug-resistant or carbapenem-resistant Acinetobacter species bloodstream infection was more frequent in oncologic patients than in non-oncologic patients, but the difference was not statistically significant: 25.4% versus 13.8% (p = 0.07).

Multivariable analysis found that oncologic status was associated with a 3.19-fold higher odds of death within 30 days (adjusted odds ratio, 95% CI 1.92–5.21; p = 0.010). Infection with multidrug-resistant or carbapenem-resistant Acinetobacter species was also associated with mortality, with an adjusted odds ratio of 2.41 (95% CI 1.12–5.18; p = 0.020). Kaplan–Meier analysis showed lower 30-day survival among oncologic patients (log-rank p = 0.020), while seven-day mortality did not differ significantly between the groups: 13.6% versus 8.3% (p = 0.30). These observations do not establish that cancer or the Acinetobacter phenotype caused the deaths. As a single-center retrospective study based on hospitalized patients, its findings are limited in generalizability and cannot fully account for differences in underlying illness, comorbidity burden or other clinical factors between groups.

Subject of Research: Associations between oncologic status, resistance determinants and 30-day mortality in multidrug-resistant bloodstream infections

Article Title: Bloodstream infections caused by multidrug-resistant organisms in patients with and without cancer: clinical outcomes and resistance determinants in a southern Italian cohort

Article References: Di Gennaro, F., Ritacco, I. A., Giliberti, V., Frallonardo, L., Cibelli, M., De Gennaro, N., Fiordelisi, D., Signorile, F., Brindicci, G., Valenzano, A., Giacchetta, I., Lizzi, L., De Iaco, G., Milano, E., Sibilio, M., Colaizzi, C., Vigna, A., De Santis, L., Santoro, C. R., … Saracino, A. (2026). Bloodstream infections caused by multidrug-resistant organisms in patients with and without cancer: clinical outcomes and resistance determinants in a southern Italian cohort. BMC Infectious Diseases. https://doi.org/10.1186/s12879-026-14475-0

Image Credits: AI Generated

DOI: 10.1186/s12879-026-14475-0

Keywords: multidrug-resistant organisms, bloodstream infections, cancer patients, 30-day mortality, KPC-producing Enterobacterales, carbapenem-resistant Acinetobacter, retrospective cohort, oncologic status, Bloodstream, infections, caused, multidrug-resistant