Bloodstream infections in patients with acute leukemia: A review
Abstract
Introduction: Acute leukemia (AL) is a life-threatening hematologic malignancy marked by the rapid expansion of immature blood cells and profound immune suppression. This immunocompromised state renders patients highly susceptible to bacterial infections, particularly bloodstream infections, which occur in 11% to 38% of cases and are a leading cause of morbidity and mortality. Objective: This review provides an in-depth analysis of the bacterial infection burden in AL patients, focusing on common pathogens, risk factors, diagnostic hurdles, and clinical management. Results: Gram-positive bacteria, such as methicillin-resistant Staphylococcus aureus, coagulase-negative staphylococci, and enterococci, along with Gram-negative pathogens like Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa, represent the most frequently isolated organisms. Both nosocomial and community-acquired infections are examined, with particular attention to the rise of multidrug-resistant strains. Risk factors for infection include prolonged neutropenia, chemotherapy, central venous catheters, and extended hospitalization. Diagnostic complexity arises from non-specific symptoms and delayed pathogen identification, making timely, accurate diagnosis critical. Advances in culture-independent testing and imaging are improving detection but remain underused. The cornerstone of effective management includes prompt empirical antibiotic therapy, targeted prophylaxis, and rigorous infection…
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