Mortality risk factors and fulminant sub-phenotype in anaerobic bacteremia: a 10-year retrospective, multicenter, observational cohort study.

PURPOSE: During the last decade, the incidence of anaerobic bacteremia (AB) has been increasing. Patients with AB may develop complex underlying diseases, which can occasionally be accompanied by fatal or fulminant outcomes. However, the risk factors for AB-related mortality remain unclear. Herein, we sought to elucidate the risk factors for AB-related mortality. METHODS: In this multicenter, retrospective, observational study, we enrolled patients with culture-proven AB from six tertiary hospitals in Japan, between January 2012 and December 2021. Data on patient and infection characteristics, laboratory findings, treatment, and outcome were collected, and their associations with mortality were analyzed. RESULTS: A total of 520 participants were included. The 30-day mortality in the study cohort was 14.0% (73 patients), and malignant tumors were frequently observed comorbidities in 48% of the entire cohort. Multivariable logistic regression analysis showed a Charlson comorbidity score of > 6, serum creatinine level of > 1.17 mg/dL, and hypotension to be independent risk factors for 30-day mortality in AB (odds ratios [ORs] 2.12, 2.25, and 5.12, respectively; p < 0.05), whereas drainage significantly reduced this risk (OR, 0.28; p < 0.0001). Twelve patients (2.3% of the whole cohort and 16.4% of the deceased patients) presented with extremely rapid progression leading to fatal outcome, consistent with "fulminant AB." CONCLUSIONS: This study identified acute circulatory dysfunction and performance of drainage as independent predictive factors for 30-day AB-related mortality and revealed the existence of a fulminant AB sub-phenotype. Our findings could serve as a practical guide to predict the clinical outcomes of AB.

Hipertermia peritoneal en la prevención de recurrencia peritoneal debida a cáncer gástrico / Peritoneal hyperthermia in the prevention of peritoneal recurrence due to gastric cancer

El cáncer gástrico es aún un importante problema de salud en Chile. El compromiso de la serosa gástrica es probablemente la causa de recurrencia peritoneal y, por ende, responsable en gran parte del pobre pronóstico de dicha enfermedad. Con el fin de disminuir la recurrencia peritoneal en pacientes con compromiso seroso, empleamos hipertermia peritoneal asociada a quimioterapia en 11 pacientes operados por un cáncer gástrico. La sobrevida de los 11 pacientes fue superior comparada a un control histórico y reacciones adversas no fueron observadas. De estos resultados, planteamos la posibilidad del empleo de hipertermia en pacientes con compromiso seroso