The colonization of Extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) in bloodstream infections (BSIs) has been increased dramatically worldwide, and it was associated with worse clinical outcomes in patients with malignancy. We performed the meta-analysis to investigate the prognosis and risk factors in BSIs caused by ESBL-PE in oncological patients. PubMed, EMBASE, and Cochrane Library were searched for related studies. All-cause mortality was considered as the primary outcome. Subgroup analyses, meta-regression analyses, and sensitivity analysis were used to investigate heterogeneity and reliability in results. 6,729 patients from 25 studies were eligible. Six studies enrolled oncological patients with BSIs caused by ESBL-PE only, while 19 studies both enrolled ESBL-PE and non-ESBL-PE infections. The results showed that BSIs caused by ESBL-PE in patients with malignancy was associated with higher mortality than non-ESBL-PE infections (RR = 2.21, 95% CI: 1.60–3.06, P < 0.001), with a significant between-study heterogeneity (I2 =78.3%, P < 0.001). Subgroup analyses showed that children (RR = 2.80, 95% CI: 2.29–3.43, P < 0.001) and hematological malignancy (RR = 3.20, 95% CI: 2.54–4.03, P < 0.001) were associated with a higher mortality. Severe sepsis/ septic shock, pneumonia, and ICU admission were the most common predictors of mortality. Our study identified that BSIs caused by ESBL-PE in patients with malignancy were associated with worse clinical outcomes compared with non-ESBL-PE infections. Furthermore, children and hematological malignancy were associated with higher mortality. Severe sepsis/ septic shock, pneumonia, and ICU admission were the most common predictors of mortality.

中文翻译：

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恶性肿瘤患者产超广谱β-内酰胺酶肠杆菌引起血流感染的临床结果和预后因素：荟萃分析

产超广谱 β-内酰胺酶肠杆菌科 (ESBL-PE) 在血流感染 (BSI) 中的定植在全球范围内急剧增加，并且与恶性肿瘤患者的较差临床结果相关。我们进行了荟萃分析，以研究 ESBL-PE 引起的肿瘤患者 BSI 的预后和危险因素。检索了 PubMed、EMBASE 和 Cochrane 图书馆的相关研究。全因死亡率被认为是主要结果。亚组分析、荟萃回归分析和敏感性分析用于研究结果的异质性和可靠性。来自 25 项研究的 6,729 名患者符合条件。6 项研究纳入了仅由 ESBL-PE 引起的 BSI 肿瘤患者，而 19 项研究同时纳入了 ESBL-PE 和非 ESBL-PE 感染。结果表明，与非 ESBL-PE 感染相比，由 ESBL-PE 引起的恶性肿瘤患者的 BSI 与更高的死亡率相关（RR = 2.21，95% CI：1.60-3.06，P < 0.001），研究间显着异质性（I2 = 78.3%，P < 0.001）。亚组分析显示，儿童（RR = 2.80，95% CI：2.29-3.43，P < 0.001）和血液系统恶性肿瘤（RR = 3.20，95% CI：2.54-4.03，P < 0.001）与较高的死亡率相关。严重脓毒症/感染性休克、肺炎和入住 ICU 是死亡率的最常见预测因素。我们的研究发现，与非 ESBL-PE 感染相比，由 ESBL-PE 引起的恶性肿瘤患者的 BSI 与更差的临床结果相关。此外，儿童和血液系统恶性肿瘤与较高的死亡率有关。严重脓毒症/感染性休克、肺炎、