Background. Pancreatic cancer patients were particularly predisposed to develop Escherichia coli (E. coli) bloodstream infection (BSI); however, little information is currently available. We set out to find E. coli BSI’s risk factors in pancreatic cancer to provide valuable experience. Methods. We retrospectively analyzed the clinical data of pancreatic cancer patients (31 cases with E. coli BSI and 93 cases without BSI) by a case-control study. SPSS 17.0 was adopted to perform univariate and multivariate analyses. Bacterial resistance analysis was performed by Whonet 5.6. Results. Hospitalization days ≥7 days, number of admissions ≥2 times, surgery, chemotherapy, the type of antibiotics used ≥2 species, albumin<40.0 g/L, and prealbumin < 0.2 g/L were the potential risk factors for pancreatic cancer patients with E. coli BSI ( P < 0.1 ). Multivariate logistic regression showed hospitalization days ≥7 days (OR = 11.196, 95% CI = 0.024–0.333, P < 0.001 ), surgery (OR = 32.053, 95% CI = 0.007–0.137, P < 0.001 ), and chemotherapy (OR = 6.174, 95% CI = 0.038–0.688, P = 0.014 ) were the independent risk factors for E. coli BSI of pancreatic cancer patients. E. coli resistant to carbapenems was rare; they were susceptible to cephamycin and piperacillin/tazobactam. The 90-day mortality rate of the infected group was significantly higher than the control group (41.9% versus 8.6%, P < 0.001 ). Conclusions. Hospitalization days ≥7 days, surgery, and chemotherapy are the independent risk factors for E. coli BSI of pancreatic cancer patients, which allows us to identify patients at potential risk and perform preventive treatment in time.
Background To study the common pathogens and cancer types of bloodstream infection (BSI) in cancer patients, find the risk factors and conduct clinical analysis.Methods The clinical data of 2302 patients with BSI in Tianjin Medical University Cancer Institute and Hospital (TMUCIH) from January 2011 to December 2018 were retrospectively analyzed. 31 pancreatic cancer patients complicated with Escherichia coli BSI and 93 pancreatic cancer patients without BSI at the same period with similar sex and age were divided into infection group and non-infection group.Results 645 strains (28%) of Escherichia coli were the main pathogens causing BSI in patients with cancer. 57 cases (8.8%) of cancer patients with Escherichia coli BSI were from pancreatic oncology department, among which 31 cases were diagnosed as pancreatic cancer by pathology. Multivariate logistic regression analysis showed that hospitalization days≥7, chemotherapy and neutrophil>5.5×10 9 /L were independent risk factors for pancreatic cancer patients complicated with BSI (P < 0.05). Quantitative analysis of serum-related indicators in infection patients and non-infection patients showed significant differences between albumin, prealbumin and neutrophils in infection and non-infection group. The ratio of Escherichia coli producing extended-spectrum ß-lactamase is 49.3 and 48.1 in pancreatic cancer and non-pancreatic patients. Escherichia coli resistant to carbapenems is rare, they were highly sensitive to Cephamycin and Piperacillin/tazobactam.Conclusions Escherichia coli, the main pathogen causing BSI of cancer patients, is more common in pancreatic cancer patients. The independent risk factors include hospitalization days≥7 days, chemotherapy and neutrophils larger than 5.5×10 9 /L. Quantitative indicators of neutrophil counts, albumin and prealbumin contribute to the early diagnosis of bloodstream infections. Early use of medication, while timely adjustment based on clinical drug sensitivity results will help reduce patient morbidity and mortality.
Streptococcus pneumoniae is a major respiratory pathogen responsible for many diseases in young children and elderly. Because of the increasing antibiotic resistance of pneumococci recently, the need for development of an effective vaccine is more and more urgent. Since the 7-valent conjugate vaccine was licensed in the United States in 2000, its efficacy has been widely recognized. Effort on researching polysaccharide-protein conjugate vaccine never stopped. This article reviewed the conjugate vaccines in view of the carrier proteins.
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