Carbapenem-resistant Gram-negative bacilli infections in Japanese patients with cancer

Carbapenem-resistant bacteria represent a significant challenge for patients with cancer; however, the characteristics and prognoses of carbapenem-resistant Gram-negative bacilli (CRGNB) infections in Japanese patients with cancer remain unclear. Therefore, we aimed to investigate the features and outcomes of CRGNB infections in this population. This multicenter prospective observational cohort study prospectively enrolled 167 patients with CRGNB infections, with or without cancer from April 2019 to March 2022. The 30-day mortality rate was numerically higher, although not significantly (18.2% vs. 14.0%, p = 0.45), in the cancer group than in the non-cancer group. The average length of hospital stay was similar (44.6 days vs. 51.0 days, p = 0.55). Similarly, the incidence of the composite outcome-defined as the 30-day mortality or events associated with worsening clinical course-was also not significantly different (56.1% vs. 43.6%, p = 0.12). Propensity score analysis using inverse probability weighting showed no significant difference in the 30-day mortality and average length of hospital stay (p = 0.25 and 0.66). However, the incidence of the composite outcome was significantly higher in the cancer group (odds ratio, 2.36; p = 0.02). Patients with cancer and CRGNB infection experienced worse composite outcomes than those without cancer, highlighting the need for preventive measures for CRGNB infections in this population.