TY - JOUR
T1 - 28-day all-cause mortality and associated factors in cancer patients with bacteremia at a peruvian referral center
AU - Vera, Yosué
AU - Zamudio, Nicolás Ismael
AU - Rojas, Bruno Eduardo
AU - Cárcamo, Cesar
AU - Legua, Pedro
AU - Delfin, Brian
AU - Rivera, Dany
AU - Tutaya, Kathiuska
AU - Villavicencio, Karol
AU - Palomino, Angie
AU - Monsalve, Sissy
AU - Montenegro, Paola
AU - Aguilar, Ivan
AU - Robles, Maribel
AU - Rosa, Yenka La
AU - Cardenas, Giuliana
AU - Young, Frank
AU - Seas, Carlos Rafael
N1 - Publisher Copyright:
© 2026 Vera et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2026/5
Y1 - 2026/5
N2 - Introduction The global prevalence of cancer has increased in recent decades. Cancer patients are especially vulnerable to invasive infections like bacteremia. In Peru, the rising incidence of bloodstream infections caused by resistant pathogens has become a major public health issue. There is limited information about this complication in the Peruvian cancer population. No previous local studies have assessed mortality or explored the impact of antimicrobial resistance on patient outcomes in this group. Methods This study aimed to evaluate 28-day all-cause mortality and its associated factors among cancer patients with bacteremia at a referral cancer center in Lima. We retrospectively analyzed data from first episodes of bacteremia in hospitalized adult patients between July 2020 and June 2024. Results A total of 293 patients were included in the study. The mean age was 65.4 ± 15.3 years, and 53.9% were female. Most patients had solid tumors (84.3%) and active disease (91.8%), with digestive cancers being the most common (34.1%). The 28-day all-cause mortality rate was 32.1%. Empirical antimicrobial therapy was appropriate in 80.7% of cases. Gram-negative bacteria (GNB) predominated (82.8%), with Escherichia coli being the most frequently isolated pathogen (45.7%). Among Enterobacteriaceae, 43.6% were extended-spectrum beta-lactamase (ESBL) producers, and 3.3% of GNB were carbapenem-resistant. Multivariable Poisson regression identified the Charlson Comorbidity Index (RR 1.1; 95% CI 1.1–1.2), sepsis (RR 2.3; 95% CI 1.3–3.8), septic shock (RR 3.0; 95% CI 1.9–4.6), respiratory failure (RR 1.6; 95% CI 1.2–2.2), Coagulase-negative Staphylococci (CoNS) bacteremia (RR 1.8; 95% CI 1.2–2.6) and primary source (RR 2.8; 95% CI 1.5–5.1) as independent factors associated with increased 28-day mortality. Conclusion At this cancer referral center, one-third of patients with bacteremia died within 28 days. Mortality was primarily caused by the severity of infection, comorbidities and specific bacteremia characteristics, rather than antimicrobial resistance.
AB - Introduction The global prevalence of cancer has increased in recent decades. Cancer patients are especially vulnerable to invasive infections like bacteremia. In Peru, the rising incidence of bloodstream infections caused by resistant pathogens has become a major public health issue. There is limited information about this complication in the Peruvian cancer population. No previous local studies have assessed mortality or explored the impact of antimicrobial resistance on patient outcomes in this group. Methods This study aimed to evaluate 28-day all-cause mortality and its associated factors among cancer patients with bacteremia at a referral cancer center in Lima. We retrospectively analyzed data from first episodes of bacteremia in hospitalized adult patients between July 2020 and June 2024. Results A total of 293 patients were included in the study. The mean age was 65.4 ± 15.3 years, and 53.9% were female. Most patients had solid tumors (84.3%) and active disease (91.8%), with digestive cancers being the most common (34.1%). The 28-day all-cause mortality rate was 32.1%. Empirical antimicrobial therapy was appropriate in 80.7% of cases. Gram-negative bacteria (GNB) predominated (82.8%), with Escherichia coli being the most frequently isolated pathogen (45.7%). Among Enterobacteriaceae, 43.6% were extended-spectrum beta-lactamase (ESBL) producers, and 3.3% of GNB were carbapenem-resistant. Multivariable Poisson regression identified the Charlson Comorbidity Index (RR 1.1; 95% CI 1.1–1.2), sepsis (RR 2.3; 95% CI 1.3–3.8), septic shock (RR 3.0; 95% CI 1.9–4.6), respiratory failure (RR 1.6; 95% CI 1.2–2.2), Coagulase-negative Staphylococci (CoNS) bacteremia (RR 1.8; 95% CI 1.2–2.6) and primary source (RR 2.8; 95% CI 1.5–5.1) as independent factors associated with increased 28-day mortality. Conclusion At this cancer referral center, one-third of patients with bacteremia died within 28 days. Mortality was primarily caused by the severity of infection, comorbidities and specific bacteremia characteristics, rather than antimicrobial resistance.
UR - https://www.scopus.com/pages/publications/105039908772
U2 - 10.1371/journal.pone.0349381
DO - 10.1371/journal.pone.0349381
M3 - Artículo
C2 - 42172301
AN - SCOPUS:105039908772
SN - 1932-6203
VL - 21
JO - PLoS ONE
JF - PLoS ONE
IS - 5 May
M1 - e0349381
ER -