Publications

Authors:

Cattaneo, C; Di Blasi, R; Skert, C; Candoni, A; Martino, B; Di Renzo, N; Delia, M; Ballanti, S; Marchesi, F; Mancini, V; Orciuolo, E; Cesaro, S; Prezioso, L; Fanci, R; Nadali, G; Chierichini, A; Facchini, L; Picardi, M; Malagola, M; Orlando, V; Trecarichi, E M; Tumbarello, M; Aversa, F; Rossi, G; Pagano, L

Title:

Bloodstream infections in haematological cancer patients colonized by multidrug-resistant bacteria

Year:

2018

Type of item:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Language:

Inglese

Referee:

No

Name of journal:

Annals of Hematology

ISSN of journal:

0939-5555

N° Volume:

97

Number or Folder:

9

Page numbers:

1717-1726

Keyword:

Bloodstream infections; Colonization; Haematologic patients; Multidrug-resistant bacteria; Adolescent; Adult; Aged; Aged, 80 and over; Bacteremia; Bacterial Infections; Catheter-Related Infections; Child; Child, Preschool; Female; Hematologic Neoplasms; Humans; Infant; Infant, Newborn; Male; Middle Aged; Young Adult; Drug Resistance, Multiple, Bacterial

Short description of contents:

Infections by multidrug-resistant (MDR) bacteria are a worrisome phenomenon in hematological patients. Data on the incidence of MDR colonization and related bloodstream infections (BSIs) in haematological patients are scarce. A multicentric prospective observational study was planned in 18 haematological institutions during a 6-month period. All patients showing MDR rectal colonization as well as occurrence of BSI at admission were recorded. One-hundred forty-four patients with MDR colonization were observed (6.5% of 2226 admissions). Extended spectrum beta-lactamase (ESBL)-producing (ESBL-P) enterobacteria were observed in 64/144 patients, carbapenem-resistant (CR) Gram-negative bacteria in 85/144 and vancomycin-resistant enterococci (VREs) in 9/144. Overall, 37 MDR-colonized patients (25.7%) developed at least one BSI; 23 of them (62.2%, 16% of the whole series) developed BSI by the same pathogen (MDRrel BSI), with a rate of 15.6% (10/64) for ESBL-P enterobacteria, 14.1% (12/85) for CR Gram-negative bacteria and 11.1% (1/9) for VRE. In 20/23 cases, MDRrel BSI occurred during neutropenia. After a median follow-up of 80 days, 18 patients died (12.5%). The 3-month overall survival was significantly lower for patients colonized with CR Gram-negative bacteria (83.6%) and VRE (77.8%) in comparison with those colonized with ESBL-P enterobacteria (96.8%). CR-rel BSI and the presence of a urinary catheter were independent predictors of mortality. MDR rectal colonization occurs in 6.5% of haematological inpatients and predicts a 16% probability of MDRrel BSI, particularly during neutropenia, as well as a higher probability of unfavourable outcomes in CR-rel BSIs. Tailored empiric antibiotic treatment should be decided on the basis of colonization.

Product ID:

106305

Handle IRIS:

11562/990434

Last Modified:

November 15, 2022

Bibliographic citation:

Cattaneo, C; Di Blasi, R; Skert, C; Candoni, A; Martino, B; Di Renzo, N; Delia, M; Ballanti, S; Marchesi, F; Mancini, V; Orciuolo, E; Cesaro, S; Prezioso, L; Fanci, R; Nadali, G; Chierichini, A; Facchini, L; Picardi, M; Malagola, M; Orlando, V; Trecarichi, E M; Tumbarello, M; Aversa, F; Rossi, G; Pagano, L, Bloodstream infections in haematological cancer patients colonized by multidrug-resistant bacteria «Annals of Hematology » , vol. 97 , n. 9 , 2018 , pp. 1717-1726

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