Factors influencing the early mortality in haematological malignancy patients with nosocomial Gram negative bacilli bacteraemia: a retrospective analysis of 154 cases

Abstract

Haematological malignancy patients who require ICU care are at high risk for early mortality related to GNB bacteraemia. Based on the local findings pointing out high rate of multidrug resistance, carbapenems combined with colistin seems to be a reasonable approach as empirical treatment of these patients. However, increasing carbapenem resistance rate is of concern.

Risk Factors for Resistance and Mortality in Patients with Extensively Resistant Acinetobacter Bacteremia in Taleghani Hospital in Tehran, Iran

“…Of the five A. lwoffii cases, no XDR strain was isolated. In most other studies, in line with our study, the prevalence of A.Lwoffii has been much lower than the prevalence of A. baumannii; moreover, the prevalence of MDR A. lwoffii has been low and no case of XDR has been reported (9,20).…”

“…Indeed similar to other studies, these factors in immunocompromised patients make them prone to infections caused by Acinetobacter spp. ; but other factors are more important in developing resistance (3,5,9,22).…”

“…such as bacteremia and multiple organ failures are prone to occur in severely immunocompromised patients (2,3,5). Several studies have reported the high prevalence of carbapenemresistant strains in these patients (3,9,10). It is also emphasized that some factors including admission to intensive care unit (ICU), mechanical ventilation, two or more organ Copyright © 2018, Author(s).…”

Which Multidrug-Resitant Bacteria are Emerging in Patients with Hematological Malignancies?: One-Year Report

“…Carbapenem therapy is likely to cause to the selection of carbapenem-resistant Gram-negative bacteria during antibacterial treatment of hematological patients [12]. The rates of carbapenem resistance observed among our bacteremia isolates were similar to the rate of 22 % that was reported in a study from Turkey [13]. Colistin monotherapy achieved clinical responses in half of patients (3/6) with CR-GNB.…”

“…The rate of ESBL production among our bacteremia isolates (20 %) was lower than those reported in other studies from Turkey, which reported infection rates of 33 and 25 % [11,13]. While 80 % of our patients with bacteremia attacks caused by CS-GNB were treated with noncarbapenem-based beta-lactam anti-pseudomonal antibiotics, three of four (75 %) bacteremia attacks caused by ESBL-producing GNB were treated with carbapenembased therapy.…”