Patient Characteristics
Between January 2010 and June 2020, approximately 1053 positive blood cultures were collected from hematological wards in our three comprehensive hospitals. BSIs occurred in 363 patients diagnosed with ALL, including 73 children (aged <15 years), 180 AYAs patients (ages 15–39 years), and 110 adult patients (age >39 years). Further details regarding the patient characteristics are shown in Table 1. Over half of the included patients were male, with an incidence of 65.8%, 58.9%, and 55.5% in children, AYAs, and adults, respectively.
The majority (44.4%) of patients was in the initial diagnosis of disease states, followed by relapsed or uncontrolled disease states (34.5%). Patients with AYAs had the greatest number of profound neutropenia episodes during the infection phase (91.7%), which was higher than that in children (54.8%, P < 0.001). Similarly, the proportion of patients with hospitalization days longer than 14 days was also significantly higher in AYAs than in children (92.2% vs. 58.9%, respectively, P < 0.001). Prior antimicrobial exposure occurred more frequently in patients with AYAs than in children (70% vs. 35.6%, respectively, P < 0.001). There was no significant difference in the three groups between previous antibiotic therapy before BSIs. The percentages of patients using sensitive antibiotics in children, AYAs, and adults in the process of BSIs were 89%, 85.6%, and 90%, respectively, as the rates of 72-h IIAT were 30.1%, 29.4%, and 31.8%, respectively. The laboratory findings between AYAs and children showed distinct characteristics; the proportion of patients with platelet (PLT) count lower than 10*10^9/L was higher in the AYAs group than in the children (67.2% vs. 24.7%, P<0.001), as was the proportion with hemoglobin lower than 70 g/dL (86.1% vs. 65.8%, P< 0.001) and albumin levels lower than 30 g/L (55% vs. 35.6%, P=0.005). There was no difference in the survival disadvantages of AYAs compared to the other two groups, and the 30-day mortality rates of children, AYAs, and adults were 11.0%, 16.1%, and 22.7%, respectively.