Comparison of <i>Enterococcus faecium</i> Bacteremic Isolates from Hematologic and Non-hematologic Patients: Differences in Antimicrobial Resistance and Molecular Characteristics

Cho, Sung‐Yeon; Park, Yeon Joon; Cho, Hanwool; Park, Dong Jin; Yu, Jin Kyung; Oak, Hayeon Caitlyn; Lee, Dong Gun

doi:10.3343/alm.2018.38.3.226

Cited by 11 publications

(7 citation statements)

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“…Early distinction of fever is needed to provide immediate antibiotic treatment. Therefore, in patients with suspicion of systemic bacterial infection, timely and adequate clinical decision making is important and blood culture is recommended [2–4].…”

Section: Introductionmentioning

confidence: 99%

Serum procalcitonin as an independent diagnostic markers of bacteremia in febrile patients with hematologic malignancies

et al. 2019

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BackgroundSerum procalcitonin (PCT) and C-reactive protein (CRP) are biomarkers of infection. In patients with hematologic disorders with or without hematopoietic stem cell transplantation (HSCT), it is difficult to distinguish bloodstream infections from aseptic causes of febrile episodes. The objective of this study was to investigate diagnostic values of PCT and CRP in predicting systemic bacterial infection in patients with hematologic malignancies.MethodsClinical and laboratory data of 614 febrile episode cases from 511 patients were analyzed. Febrile episodes were classified into four groups: (1) culture-positive bacterial infection by Gram-positive cocci (GPC), (2) culture-positive bacterial infection by Gram-negative bacilli (GNB), (3) fungal infection, and (4) viral infection or a noninfectious etiology.ResultsOf 614 febrile cases, systemic bacterial infections were confirmed in 99 (16.1%) febrile episodes, including 38 (6.2%) GPC and 61 (9.9%) GNB infections. PCT levels were significantly higher in GNB infectious episodes than those in febrile episodes caused by fungal infection (0.58 ng/mL (95% CI: 0.26–1.61) vs. 0.22 ng/mL (0.16–0.38), P = 0.047). Bacterial infectious episodes showed higher PCT and CRP levels than non-bacterial events (PCT: 0.49 (0.26–0.93) ng/mL vs. 0.20 (0.18–0.22) ng/mL, P < 0.001; CRP: 76.6 (50.5–92.8) mg/L vs. 58.0 (51.1–66.5) mg/L, P = 0.036). For non-neutropenic febrile episodes, both PCT and CRP discriminated bacteremia from non-bacteremia. However, in neutropenic febrile episodes, PCT only distinguished bacteremia from non-bacteremia. In non-neutropenic episode, both PCT and CRP showed good diagnostic accuracy (AUC: 0.757 vs. 0.763). In febrile neutropenia, only PCT discriminated bacteremia from non-bacterial infection (AUC: 0.624) whereas CRP could not detect bacteremia (AUC: 0.500, 95% CI: 0.439–0.561, P > 0.05).ConclusionsIn this single-center observational study, PCT was more valuable than CRP for discriminating between bacteremia and non-bacteremia independent of neutropenia or HSCT.

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Section: Introductionmentioning

confidence: 99%

Serum procalcitonin as an independent diagnostic markers of bacteremia in febrile patients with hematologic malignancies

et al. 2019

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“…The positive blood culture bottle was sent to Vitek MS (bioMérieux, Marcy L'Etoile, France) and Vitek 2 (bioMérieux, Hazelwood, MO, USA) for direct identification and antimicrobial susceptibility testing. The resulting minimum inhibitory concentration values were classified according to the guidelines set forth by the Clinical and Laboratory Standards Institute [ 15 16 17 ].…”

Section: Methodsmentioning

confidence: 99%

Bloodstream Infections in Patients with Hematologic Diseases: Causative Organisms and Factors Associated with Resistance

et al. 2022

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Background Patients with hematologic diseases are at high risk of bloodstream infections (BSIs). This study aimed to analyze clinical features and distributions of microorganisms in patients with hematologic diseases presenting at a tertiary care university-affiliated hospital in Korea. Materials and Methods We retrospectively reviewed all BSI episodes recorded in patient medical records at two hematologic wards of the Catholic Hematology Hospital from January to December 2020. Our aim was to analyze demographic and clinical characteristics relevant to BSIs. We also described the antimicrobial resistance patterns of the major pathogens identified in this study, and evaluated risk factors for extended-spectrum beta-lactamase (ESBL) production in Enterobacteriaceae isolates and for vancomycin resistance in enterococcal isolates. Results A total of 380 BSI episodes were identified in 334 patients over the course of 1 year (monomicrobial BSI episodes, 86.1%; polymicrobial BSI episodes, 13.9%). Gram-negative bacteria accounted for 242 isolates (54.8%). The most frequently isolated Gram-negative bacteria isolates were Escherichia coli (107 [24.2%]) followed by Klebsiella spp. (72 [16.3%]), Pseudomonas spp. (21 [4.8%]), and Enterobacter spp. (12 [2.7%]). The most commonly identified Gram-positive bacteria were Enterococcus spp. (72 [16.3%]) followed by viridans streptococci (54 [12.2%]), coagulase-negative staphylococci (CoNS) (24 [5.4%]), and Corynebacterium spp. (22 [5.0%]). ESBL-producing Enterobacteriaceae accounted for 25.1% of the total distribution. Among 54 Enterococcus faecium isolates, 100.0% were resistant to ampicillin and 55.6% showed resistance to vancomycin, while 100.0% (n = 12) of Enterococcus faecalis isolates were susceptible to ampicillin and vancomycin, respectively. Use of ciprofloxacin prophylaxis (odds ratio: 5.20; 95% confidence interval: 1.11 - 24.34; P = 0.04) was an independent risk factor for ESBL production in Enterobacteriaceae BSIs. Conclusion Compared with the results of a previous study conducted at the same institution, our findings demonstrated that Gram-negative bacteria remained dominant pathogens in BSIs occurring in patients with hematologic diseases. Our findings also demonstrated a comparatively decreased prevalence of ESBL-producing Enterobacteriaceae in the evaluated BSIs. However, the prevalence of enterococcal BSIs had not decreased, and the proportion of vancomycin-resistant Enterococcus isolates from E. faecium BSIs had increased. In addition, we found that ciprofloxacin p...

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“…Early distinction of infection-related fever and immediate antibiotic treatment are extremely important for treating these patients. Therefore, adequate and timely clinical decision-making is important, and a blood culture is recommended for patients with suspected systemic bacterial infection [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Association of Procalcitonin with the Patient’s Infection Characteristics and Prognosis after Hematopoietic Stem Cell Transplantation

Nan

et al. 2022

Disease Markers

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Objective. To study whether procalcitonin (PCT) is an important indicator of infection with or without agranulocytosis and to reveal whether PCT can distinguish between infected sites and affect prognosis after hematopoietic stem cell transplantation (HSCT). Method. In the present study, 682 patients with HSCT were enrolled, and their clinical characteristics were noted. Their blood culture and inflammatory and biochemical indicators were studied. The patients were divided into respective groups according to the degree of agranulocytosis, type of bacterial infection, infected sites, and prognosis. Results. The PCT, CRP, and D-dimer levels were significantly improved in patients with positive blood culture results compared to the case for those with negative blood culture results. The PCT level was the highest in the gram-negative group. The levels of PCT and D-dimer were significantly elevated in patients with infection and agranulocytosis after HSCT compared to those in the nonagranulocytosis cohort. Interestingly, no significant difference in the PCT level was observed among any of the eight foci. Lower PCT levels were associated with higher survival in patients with infection after HSCT. Conclusion. Among patients that underwent HSCT, PCT levels were significantly elevated in those with infection and agranulocytosis, with the levels being specifically high in the gram-negative group. Moreover, lower PCT levels were associated with higher survival in patients with infection after HSCT.

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Comparison of Enterococcus faecium Bacteremic Isolates from Hematologic and Non-hematologic Patients: Differences in Antimicrobial Resistance and Molecular Characteristics

Cited by 11 publications

References 29 publications

Serum procalcitonin as an independent diagnostic markers of bacteremia in febrile patients with hematologic malignancies

Serum procalcitonin as an independent diagnostic markers of bacteremia in febrile patients with hematologic malignancies

Bloodstream Infections in Patients with Hematologic Diseases: Causative Organisms and Factors Associated with Resistance

Association of Procalcitonin with the Patient’s Infection Characteristics and Prognosis after Hematopoietic Stem Cell Transplantation

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