Microbial infections in lymphocytic leukemia: A 12 year analysis in the Saudi population.

[BACKGROUND] Understanding the landscape of bloodstream infections (BSIs) in Lymphocytic leukemia patients with Acute Lymphoblastic Leukemia (ALL) and Chronic Lymphocytic Leukemia (CLL) is crucial for optimizing treatment and improving patient outcomes.

[METHODS] This retrospective study investigated the prevalence and characteristics of BSIs in these patients diagnosed between 2008 and 2020 at King Abdulaziz University Hospital.

[RESULTS] Among 1488 patients, 72 cases of BSI were identified, with ALL being the predominant diagnosis (64 cases) and CLL (8 cases). A significant male bias was observed (53 males). Age distribution differed between ALL and CLL, with pediatric patients dominating ALL cases (49) while CLL was primarily diagnosed in the elderly (7 cases). Analysis of causative pathogens revealed a diverse spectrum. Bacterial infections were most prevalent (62 cases), followed by fungal (7 cases) and mixed bacterial-fungal infections (3 cases). Co-infection analysis identified frequent pairings like Staphylococcus with MRSA, E. coli with ESBL, and Klebsiella pneumoniae with Candida parapsilosis. CLL patients displayed a distinct infection pattern, with a higher prevalence of Streptococcus and Candida albicans. We observed differences in the prevalence of specific pathogens based on ALL or CLL diagnosis and remission state. Survival analysis indicated poorer outcomes with increasing age, highlighting the heightened risk associated with advanced age.

[CONCLUSIONS] Our findings emphasize the importance of tailoring infection management strategies based on patient demographics, diagnosis, and remission status for improved outcomes.