The Impact of Bacterial Biofilms on End-Organ Disease and Mortality in Patients with Hematologic Malignancies Developing a Bloodstream Infection
Enea Gino Di Domenico, Francesco Marchesi, Ilaria Cavallo, Luigi Toma, Francesca Sivori, Elena Papa, Antonio Spadea, Giuseppina Cafarella, Irene Terrenato, Grazia Prignano, Fulvia Pimpinelli, Arianna Mastrofrancesco, Giovanna D’Agosto, Elisabetta Trento, Aldo Morrone, Andrea Mengarelli, Fabrizio Ensoli
Abstract
Bacterial bloodstream infection (BSI) is a significant complication in hematologic patients and is associated with high mortality rates. Despite improvements in BSI management, factors leading to sepsis are understood only partially. This study analyzes the contribution of bacterial biofilm on BSI development and mortality in patients with hematological malignancies (HMs). In this work, weak biofilm producers (WBPs) were significantly more abundant than strong biofilm producers (SBPs). However, when present, SBP bacteria raised the risk of end-organ disease in HM patients developing a BSI. Besides, SBPs, together with a multidrug-resistant (MDR) phenotype, independently and significantly concur at increasing the risk of death in HM patients. The characterization of microbial biofilms may provide key information for the diagnosis and therapeutic management of BSI and may help develop novel strategies to either eradicate or control harmful microbial biofilms.