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Erschienen in: Supportive Care in Cancer 1/2016

01.01.2016 | Original Article

Fecal ESBL Escherichia coli carriage as a risk factor for bacteremia in patients with hematological malignancies

verfasst von: Patricia Cornejo-Juárez, Juan Antonio Suárez-Cuenca, Patricia Volkow-Fernández, Jesús Silva-Sánchez, Humberto Barrios-Camacho, Esmeralda Nájera-León, Consuelo Velázquez-Acosta, Diana Vilar-Compte

Erschienen in: Supportive Care in Cancer | Ausgabe 1/2016

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Abstract

Purpose

The purpose of this study is to evaluate the impact of fecal extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC) colonization for bloodstream infection (BSI), clinical outcome, and costs in patients with hematologic malignancies (HM) and severe neutropenia.

Methods

This is a cohort study, carried out at a cancer-referral hospital. The study population comprises patients with HM, hospitalized prior to administration of the first chemotherapy cycle. A stool culture was taken during the first 48 h; they were grouped as colonized by ESBL-EC or non-ESBL-EC. Patients were followed upon completion of chemotherapy or death. The sum of the days of antibiotics and the length of stay of all hospitalizations in the different cycles of chemotherapy were recorded.

Results

We included 126 patients with a recent diagnosis of HM, grouped as 63 patients colonized by ESBL-EC and 63 colonized by non-ESBL-EC, aged 42 ± 16 years old, 78 males (62 %). BSI by ESBL-EC developed in 14 patients (22.2 %) colonized by the same strain and in 5 (7.9 %) in the group colonized with non-ESBL-EC. BSI by non-ESBL-EC was observed in 3 patients (4.7 %) colonized by ESBL-EC and in 17 (26.9 %) patients colonized by non-ESBL-EC. Colonization with ESBL-EC increased the risk of BSI by the same strain (relative risk (RR) = 3.4, 95 % confidence interval (95 % CI) 1.5–7.8, p = 0.001), shorter time to death (74 ± 62 vs. 95 ± 83 days, p < 0.001), longer hospital stay (64 ± 39 vs. 48 ± 32 days, p = 0.01), and higher infection-related costs ($6528 ± $4348 vs. $4722 ± $3173, p = 0.01). There was no difference in overall mortality between both groups.

Conclusions

Fecal colonization by ESBL-EC is associated with increased risk of BSI by this strain, longer hospital stay, and higher related costs.
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Metadaten
Titel
Fecal ESBL Escherichia coli carriage as a risk factor for bacteremia in patients with hematological malignancies
verfasst von
Patricia Cornejo-Juárez
Juan Antonio Suárez-Cuenca
Patricia Volkow-Fernández
Jesús Silva-Sánchez
Humberto Barrios-Camacho
Esmeralda Nájera-León
Consuelo Velázquez-Acosta
Diana Vilar-Compte
Publikationsdatum
01.01.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Supportive Care in Cancer / Ausgabe 1/2016
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-015-2772-z

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