Recent changes in bacterial epidemiology and the emergence of fluoroquinolone-resistant Escherichia coli among patients with haematological malignancies: results of a prospective study on 823 patients at a single institution

Cattaneo, Chiara; Quaresmini, Giulia; Casari, Salvatore; Capucci, Maria Adele; Micheletti, M; Borlenghi, Erika; Signorini, Liana; Re, Alessandro; Carosi, Giampiero; Rossi, Giuseppe

doi:10.1093/jac/dkm514

Cited by 127 publications

(91 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[3][4][5] Recently, the widespread emergence of FQ-resistant or multidrug-resistant microorganisms in hematologyoncology units has been suggested to compromise the effectiveness of routine antibacterial prophylaxis with FQs in patients undergoing cytotoxic chemotherapy or HCT. [6][7][8][9][10][11][12][13][14] In our center, the isolation rate of FQ-resistant Gramnegative bacilli was high (57.1%) during a period when FQs were routinely administered as antibacterial prophylactic agents; in particular, among isolated Enterobacteriaceae strains, 66.7, 33.3 and 22.2% were resistant to levofloxacin, piperacillin and ceftazidime, respectively. 8 In an attempt to reduce the emergence of antibiotic-resistant microorganisms, we stopped using any antibacterial prophylaxis in both autologous and allogeneic HCT recipients in 2004, 8 and found that this discontinuation of FQ prophylaxis, even in the setting of myeloablative allogeneic HCT did not significantly affect early mortality after transplantation.…”

Section: Introductionmentioning

confidence: 83%

Pretransplant serum ferritin and C-reactive protein as predictive factors for early bacterial infection after allogeneic hematopoietic cell transplantation

Kanda

Mizumoto

Ichinohe

et al. 2010

Bone Marrow Transplant

View full text Add to dashboard Cite

Although fluoroquinolones or other antibiotics are commonly used to prevent bacterial infections after hematopoietic cell transplantation (HCT), because of the growing presence of multidrug-resistant microorganisms, it is important to identify patients who are more likely to benefit from antibacterial prophylaxis. To evaluate risk factors for early bacterial infection after allogeneic HCT, we retrospectively analyzed clinical data for 112 consecutive adult patients with hematological malignancies who received transplants without any antibacterial prophylaxis. The cumulative incidence of bacterial infection at 30 days after transplantation was 16%. Among various pre-transplant factors, only high serum ferritin (4700 ng/mL, 47 patients) and high C-reactive protein (CRP) (40.3 mg/dL, 28 patients) levels were significantly associated with the development of bacterial infection in a multivariate analysis (hazard ratio (95% confidence interval): ferritin, 4.00 (1.32-12.17); CRP, 3.64 (1.44-9.20)). In addition, septic shock and sepsis with organ failure were exclusively observed in patients who had high ferritin and/or high CRP levels. These results suggest that pretransplant serum ferritin and CRP levels can be useful markers for predicting the risk of early bacterial infection after allogeneic HCT. It may be prudent to limit antibacterial prophylaxis to patients with predefined risk factors to ensure the safety of HCT with the use of fewer antibiotics.

show abstract

Section: Introductionmentioning

confidence: 83%

Pretransplant serum ferritin and C-reactive protein as predictive factors for early bacterial infection after allogeneic hematopoietic cell transplantation

Kanda

Mizumoto

Ichinohe

et al. 2010

Bone Marrow Transplant

View full text Add to dashboard Cite

show abstract

“…1,7,12,[18][19][20][21] This may be accounted for by greater use of prophylactic antimicrobials, chiefly quinolones. 22 According to Laws et al, 19 Gram-negative bacterial infections are more severe and cause higher death rates, compared with Gram-positive bacterial infections. This may be explained by their greater virulence and resistance, and the latter is also due to their double cell membrane, which blocks the entry of some drugs.…”

Section: Discussionmentioning

confidence: 99%

Infection profile of patients undergoing autologous bone marrow transplantation in a Brazilian institution

et al. 2012

View full text Add to dashboard Cite

show abstract

“…In addition, Coagulase negative staphylococci with 17% was the predominant isolated bacteria and E. coli with 16% stood in second place (26). Moreover, Cattaneo et al (27) stated that their study was an evidence for an epidemiological shift from Gram-positive to negativebacteria in patients with hematological malignancies while E. coli was the most frequent organism. Also, there are other reports of emergence of Gram-negative bacteria mainly consisted of P. aeruginosa and Enterobacteriaceae which stands for nearly 50% of all documented infections (23).…”

Section: Staphymentioning

confidence: 97%

A Population-Based Study of Bacterial Spectrum in Febrile Neutropenic Patients

Meidani

Bagheri

Khorvash

2013

Jundishapur J Microbiol

View full text Add to dashboard Cite

Background: Because of great concerns about mortality and morbidity of infection in febrile neutropenic patients, the appropriate empirical antibiotic should be started immediately. Although there are established guidelines for the use of empirical therapy, local microbiological pattern and antibiotic susceptibility should be considered. Objectives: The current study aimed to identify the etiological pathogens in febrile neutropenic cancer patients in Isfahan, Iran. Patients and Methods:This single-centre population-based study was conducted on 81 febrile neutropenic patients referring to Sayed-AlShohada hospital, the only referral malignant care center in Isfahan, Iran. Demographic data, duration and kind of malignancy, duration from last chemotherapy, duration of fever, and also physical exam were recorded for each patient. Moreover, procalcitonin, CRP, ESR, white blood cells, hemoglobin, platelet, and absolute neutrophil count were measured. BACTEC and E-test were used for blood culturing and determining the antibiotic susceptibility. Results: Out of 81 participants, 28.4% had positive blood cultures which mostly consisted of Gram-positive microorganisms. In addition, Staphylococcus epidermidis was the most isolated Gram positive bacteria (39.1%). ESR, CRP, and procalcitonin were significantly higher in patients with positive blood culture. The risk of infection increased with raise in duration of hospital stay, catheterization, increased pulse rate, increased oral temperature, low level of oxygen saturation, decreased systolic blood pressure, and low absolute neutrophile count. However, in this case, no relationship was found among the patients' age, diastolic blood pressure, respiratory rate, duration of diagnosis, duration from last chemotherapy, duration of fever, white blood cells, hemoglobin, platelet, and finally the type of malignancies. Conclusions: It was concluded that Gram-positive bacteria were more prevalent as a cause of infection in the patients with malignancy and the most common pathogen was S. epidermidis. Larger studies are needed to determine the bacterial susceptibility of this center.

show abstract

Recent changes in bacterial epidemiology and the emergence of fluoroquinolone-resistant Escherichia coli among patients with haematological malignancies: results of a prospective study on 823 patients at a single institution

Cited by 127 publications

References 27 publications

Pretransplant serum ferritin and C-reactive protein as predictive factors for early bacterial infection after allogeneic hematopoietic cell transplantation

Pretransplant serum ferritin and C-reactive protein as predictive factors for early bacterial infection after allogeneic hematopoietic cell transplantation

Infection profile of patients undergoing autologous bone marrow transplantation in a Brazilian institution

A Population-Based Study of Bacterial Spectrum in Febrile Neutropenic Patients

Contact Info

Product

Resources

About