Carbapenem-resistant Klebsiella pneumoniae in a Febrile Neutropenia Patient With Acute Myelogenous Leukemia After Hematopoietic Stem Cell Transplantation

Asai, Satoshi; Ohshima, Toshio; Iwashita, Hideo; Ishii, Yoshikazu; Aoki, Kotaro; Minakawa, Yuki; Machida, Shinichiro; Umezawa, Kazuo; Tateda, Kazuhiro; Miyachi, Hayato

doi:10.1097/ipc.0000000000000633

Cited by 4 publications

(7 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In order to identify the occurrence of CR in HM patients and to understand its epidemiology, we reviewed series and selected case reports that report colonization or infection of HM patients with CR bacteria. These studies were undertaken in different areas of the world, including New York, New Delhi, China, Stockholm, Frankfurt, Roma, Brescia, Athens, Ankara, Cairo, and Haifa in the series studies (Tables 1−3; Cattaneo et al, 2012Cattaneo et al, , 2018Kjellander et al, 2012;Schelenz et al, 2013;Satlin et al, 2013aSatlin et al, , 2016El-Mahallawy et al, 2014;Trecarichi et al, 2015Trecarichi et al, , 2016Wang et al, 2015Wang et al, , 2017Micozzi et al, 2017;Ballo et al, 2019), and in United States, Brazil, Spain, Italy, Poland, Turkey, Israel, Japan, China, and Austria in the case reports (Table 4; Muchtar et al, 2012;Carattoli et al, 2013;Chang et al, 2013;Satlin et al, 2013b;Girmenia et al, 2015;Huang et al, 2015;Kara Leitner et al, 2015;Xing et al, 2015;Kantarcioglu et al, 2016;Tofas et al, 2016;Zhang et al, 2016Zhang et al, , 2018Majewski et al, 2017;Piedra-Carrasco et al, 2017;Asai et al, 2018). When we geolocate the regions that have reported the presence of CR bacteria in HM patients in Figure 1, it can be observed that all these studies have been reported in regions that are either endemic or have a significant increase in carbapenemase enzymes (a coincidence with regions with high levels of CR bacteria) (Figure 1).…”

Section: Carbapenem Resistance In Hematological Patients Vs the Worlmentioning

confidence: 99%

“…Unlike other continents, the etiology of CR related to HM patients in Asia is more diverse. When we examined the series and cases reports, different CR-bacterial species were detected in HM patients, including K. pneumoniae (Wang et al, 2015;Xing et al, 2015;Asai et al, 2018;Zhang et al, 2018), E. cloacae (Huang et al, 2015), E. coli (Zhang et al, 2016), and A. baumannii (Wang et al, 2015). These bacteria have been isolated either in a context of colonization (stool, sputum) or infection (mainly BSIs).…”

Section: Etiology Of Cr-bacteria In Hm Patientsmentioning

confidence: 99%

See 1 more Smart Citation

Infections Due to Carbapenem-Resistant Bacteria in Patients With Hematologic Malignancies

et al. 2020

View full text Add to dashboard Cite

In developed countries, hematological malignancies (HM) account for 8 to 10% of cancers diagnosed annually and one-third of patients with HM (HMP) are expected to die from their disease. The former wide spectrum "magic bullet," imipenem, has been ousted by the emergence of carbapenem resistant (CR) pathogens. In endemic areas, infections with CR-bacteria occur in vulnerable patients, notably in HMP, who suffer from high mortality related to infectious complications. In this work, we reviewed epidemiologic and clinical factors associated with CR-infections in adult HMP and data on CR-related mortality and antibiotic treatments in this population. We found that resistance profile of strains involved in HMP infections, mainly bacteremia, reflect local epidemiology. Significant risk factors for infections with CR-bacteria include sex male, age around 50 years old, acute leukemia, selvage chemotherapy, neutropenia, and digestive colonization by CR-bacteria. Mortality rate is high in HMP infected with CR-Enterobacteriaceae, more particularly in case of acute myeloid leukemia and unresolved neutropenia, due to inappropriate empiric management and delayed administration of targeted antibiotics, such as tigecycline, colistin, or new associations of active drugs. Thus, we developed an algorithm for clinicians, assessing the incremental risk for CRbacterial infection occurrence and mortality in febrile HMP, to guide decisions related to empirical therapeutic strategies.

show abstract

Section: Carbapenem Resistance In Hematological Patients Vs the Worlmentioning

confidence: 99%

Section: Etiology Of Cr-bacteria In Hm Patientsmentioning

confidence: 99%

Infections Due to Carbapenem-Resistant Bacteria in Patients With Hematologic Malignancies

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Meanwhile, patients were forced to receive different classes of antibiotics more frequently, which likely to cause the emergence of CRKP. 9 , 42 …”

Section: Discussionmentioning

confidence: 99%

“… 7 , 8 HSCT recipients are at high risk for hospital-acquired K. pneumoniae infections because of their long hospital stay, large-dose chemotherapy/radiotherapy/immunosuppressant/broad-spectrum antibiotics, as well as catheter implantation, intravenous hyperalimentation, and delayed hematopoietic reconstruction. 9 …”

Section: Introductionmentioning

confidence: 99%

Epidemiology, Drug Resistance, and Risk Factors for Mortality Among Hematopoietic Stem Cell Transplantation Recipients with Hospital-Acquired Klebsiella pneumoniae Infections: A Single-Center Retrospective Study from China

Liu¹,

Liu²,

Chen³

et al. 2022

IDR

View full text Add to dashboard Cite

Objective Infection is the most common complication and cause of death after hematopoietic stem cell transplantation (HSCT). Our study aims to investigate the clinical characteristics and risk factors for death of Klebsiella pneumoniae infections in HSCT recipients, so as to provide evidence for guiding antibiotic use and improving prognosis in the future. Methods The epidemiology, clinical manifestations and drug resistance rate with K. pneumoniae infections among HSCT recipients between January 1, 2012 and September 30, 2021 were retrospectively reviewed. Logistic regression model and Cox regression model were respectively used to determine the risk factors for carbapenem-resistant Klebsiella pneumoniae (CRKP) acquisition and death. Results Fifty-nine HSCT recipients suffered from K. pneumoniae infections, with a mortality rate of 42.4%. The most common site was lung, followed by blood stream. The resistance rate of K. pneumoniae to various clinically common antibiotics was high, especially CRKP, which was only sensitive to amikacin and tigecycline. Independent risk factor for CPKP acquisition was a previous infection within 3 months before transplantation (OR=10.981, 95% CI 1.474–81.809, P =0.019). Independent risk factors for mortality included interval from diagnosis to transplantation > 180 days (HR=3.963, 95% CI 1.25–12.561, P =0.019), engraftment period > 20 days (HR=8.015, 95% CI 2.355–27.279, P =0.001), non-use of anti-CMV immunoglobulin/rituximab after transplantation (HR=10.720, 95% CI 2.390–48.089, P =0.002), and PCT > 5 μg/L (HR=5.906, 95% CI 1.623–21.500, P =0.007). Conclusion K. pneumoniae infection has become a serious threat for HSCT recipients, which reminds us to pay enough attention and actively seek new strategies.

show abstract

“…HM patients are prone to multiple drug-resistant bacterial infections, especially during febrile neutropaenic episodes ( 25 , 26 ). It has been reported that the main CR-GNB strains include K. pneumoniae, K. acidogenes, Citrobacter freundi in Europe, and K. pneumoniae, Enterobacter cloacae , and Escherichia coli in Asia ( 21 , 27 – 34 ). In our study, the dominant strains were K. pneumoniae (32.1%), E. coli (18.4%), and Acinetobacter baumanii (15.8%), which was consistent with previous reports.…”

Section: Discussionmentioning

confidence: 99%

A Novel Risk Predictive Scoring Model for Predicting Subsequent Infection After Carbapenem-Resistant Gram-Negative Bacteria Colonization in Hematological Malignancy Patients

Qian

Yin

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

BackgroundThis study investigated the high-risk factors associated with the increased vulnerability for subsequent clinical CR-GNB infection in carbapenem-resistant Gram-negative bacteria (CR-GNB)-colonized hematological malignancy (HM) patients and built a statistical model to predict subsequent infection.MethodAll adult HM patients with positive rectoanal swabs culture for CR-GNB between January 2018 and June 2020 were prospectively followed to assess for any subsequent CR-GNB infections and to investigate the risk factors and clinical features of subsequent infection.ResultsA total of 392 HM patients were enrolled. Of them, 46.7% developed a subsequent clinical CR-GNB infection, with 42 (10.7%) cases of confirmed infection and 141 (36%) cases of clinically diagnosed infection. Klebsiella pneumoniae was the dominant species. The overall mortality rate of patients colonized and infected with CR-GNB was 8.6% and 43.7%. A multivariate analysis showed that remission induction chemotherapy and the duration of agranulocytosis, mucositis, and hypoalbuminemia were significant predictors of subsequent infection after CR-GNB colonization. According to our novel risk-predictive scoring model, the high-risk group were >3 times more likely to develop a subsequent infection in comparison with the low-risk group.ConclusionOur risk-predictive scoring model can early and accurately predict a subsequent CR-GNB infection in HM patients with CR-GNB colonization. The early administration of CR-GNB-targeted empirical therapy in the high-risk group is strongly recommended to decrease their mortality.

show abstract

Carbapenem-resistant Klebsiella pneumoniae in a Febrile Neutropenia Patient With Acute Myelogenous Leukemia After Hematopoietic Stem Cell Transplantation

Cited by 4 publications

References 5 publications

Infections Due to Carbapenem-Resistant Bacteria in Patients With Hematologic Malignancies

Infections Due to Carbapenem-Resistant Bacteria in Patients With Hematologic Malignancies

Epidemiology, Drug Resistance, and Risk Factors for Mortality Among Hematopoietic Stem Cell Transplantation Recipients with Hospital-Acquired Klebsiella pneumoniae Infections: A Single-Center Retrospective Study from China

A Novel Risk Predictive Scoring Model for Predicting Subsequent Infection After Carbapenem-Resistant Gram-Negative Bacteria Colonization in Hematological Malignancy Patients

Contact Info

Product

Resources

About