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10.01.2022 | Original Paper

Predictive value of surveillance cultures for bacteremia caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales among patients with hematological diseases

verfasst von: Takuya Hattori, Tatsunori Goto, Masahide Osaki, Yukiyasu Ozawa, Koichi Miyamura

Erschienen in: Infection | Ausgabe 3/2022

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Abstract

Purpose

Due to the increasing prevalence of extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales, empirical therapies with cefepime or piperacillin/tazobactam for hematology patients with febrile neutropenia have become ineffective. Carbapenems should be administered as soon as possible in such patients with ESBL bacteremia. If the surveillance culture results are consistent with the blood culture findings, the time to adequate treatment initiation can be shortened.

Methods

All consecutive patients with Enterobacterales bacteraemia who were admitted from January 2013 to December 2018 at the hematology wards were enrolled in this study. Surveillance rectal swab and blood culture results were compared.

Results

In total, 67 patients with Enterobacterales bacteremia underwent surveillance culture prior to the onset of infection. Regarding the presence or absence of ESBL-producing Enterobacterales, 64 (95.5%) patients had surveillance results concordant with blood culture results. The positive predictive value of surveillance culture for bacteremia caused by ESBL-producing Enterobacterales was 95.0%. Moreover, the negative predictive value of surveillance culture for bacteremia caused by non-ESBL-producing Enterobacterales was 95.7%.

Conclusion

The concordance rate between the surveillance rectal swab and blood cultures was highly acceptable. Surveillance rectal swab cultures are useful for identifying patients at high risk for ESBL bacteremia.

Viscoli C, Bruzzi P, Castagnola E, Boni L, Calandra T, Gaya H, et al. Factors associated with bacteraemia in febrile, granulocytopenic cancer patients. The International Antimicrobial Therapy Cooperative Group (IATCG) of the European Organization for Research and Treatment of Cancer (EORTC). Eur J Cancer. 1994. https://doi.org/10.1016/0959-8049(94)90412-x.CrossRefPubMed

Blennow O, Ljungman P, Sparrelid E, Mattsson J, Remberger M. Incidence, risk factors, and outcome of bloodstream infections during the pre-engraftment phase in 521 allogeneic hematopoietic stem cell transplantations. Transpl Infect Dis. 2014. https://doi.org/10.1111/tid.12175.CrossRefPubMed

Song Y, Himmel B, Ohrmalm L, Gyarmati P. The microbiota in hematologic malignancies. Curr Treat Options Oncol. 2020. https://doi.org/10.1007/s11864-019-0693-7.CrossRefPubMed

Ji J, Klaus J, Burnham JP, Michelson A, McEvoy CA, Kollef MH, et al. Bloodstream infections and delayed antibiotic coverage are associated with negative hospital outcomes in hematopoietic stem cell transplant recipients. Chest. 2020. https://doi.org/10.1016/j.chest.2020.06.011.CrossRefPubMedPubMedCentral

Tamma PD, Han JH, Rock C, Harris AD, Lautenbach E, Hsu AJ, et al. Carbapenem therapy is associated with improved survival compared with piperacillin-tazobactam for patients with extended-spectrum beta-lactamase bacteremia. Clin Infect Dis. 2015. https://doi.org/10.1093/cid/civ003.CrossRefPubMedPubMedCentral

Kang CI, Chung DR, Ko KS, Peck KR, Song JH. Risk factors for infection and treatment outcome of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae bacteremia in patients with hematologic malignancy. Ann Hematol. 2012. https://doi.org/10.1007/s00277-011-1247-7.CrossRefPubMed

Scheich S, Weber S, Reinheimer C, Wichelhaus TA, Hogardt M, Kempf VAJ, et al. Bloodstream infections with gram-negative organisms and the impact of multidrug resistance in patients with hematological malignancies. Ann Hematol. 2018. https://doi.org/10.1007/s00277-018-3423-5.CrossRefPubMed

Freifeld AG, Bow EJ, Sepkowitz KA, Boeckh MJ, Ito JI, Mullen CA, et al. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2011. https://doi.org/10.1093/cid/ciq147.CrossRefPubMed

Benanti GE, Brown ART, Shigle TL, Tarrand JJ, Bhatti MM, McDaneld PM, et al. Carbapenem versus Cefepime or Piperacillin-Tazobactam for empiric treatment of bacteremia due to extended-spectrum-beta-lactamase-producing Escherichia coli in patients with hematologic malignancy. Antimicrob Agents Chemother. 2019. https://doi.org/10.1128/AAC.01813-18.CrossRefPubMedPubMedCentral

10.

Cohen MJ, Block C, Levin PD, Schwartz C, Gross I, Weiss Y, et al. Institutional control measures to curtail the epidemic spread of carbapenem-resistant Klebsiella pneumoniae: a 4-year perspective. Infect Control Hosp Epidemiol. 2011. https://doi.org/10.1086/660358.CrossRefPubMedPubMedCentral

11.

Sehulster L, Chinn RY. Guidelines for environmental infection control in health-care facilities. recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). MMWR Recomm Rep. 2003;52:1–42. PubMed

12.

Kola A, Holst M, Chaberny IF, Ziesing S, Suerbaum S, Gastmeier P. Surveillance of extended-spectrum beta-lactamase-producing bacteria and routine use of contact isolation: experience from a three-year period. J Hosp Infect. 2007. https://doi.org/10.1016/j.jhin.2007.01.006.CrossRefPubMed

13.

Baba H, Nimmo GR, Allworth AM, Boots RJ, Hayashi Y, Lipman J, et al. The role of surveillance cultures in the prediction of susceptibility patterns of Gram-negative bacilli in the intensive care unit. Eur J Clin Microbiol Infect Dis. 2011. https://doi.org/10.1007/s10096-010-1146-1.CrossRefPubMed

14.

Papadomichelakis E, Kontopidou F, Antoniadou A, Poulakou G, Koratzanis E, Kopterides P, et al. Screening for resistant gram-negative microorganisms to guide empiric therapy of subsequent infection. Intensive Care Med. 2008. https://doi.org/10.1007/s00134-008-1247-9.CrossRefPubMed

15.

Reddy P, Malczynski M, Obias A, Reiner S, Jin N, Huang J, et al. Screening for extended-spectrum beta-lactamase-producing Enterobacteriaceae among high-risk patients and rates of subsequent bacteremia. Clin Infect Dis. 2007. https://doi.org/10.1086/521260.CrossRefPubMed

16.

Blot S, Depuydt P, Vogelaers D, Decruyenaere J, De Waele J, Hoste E, et al. Colonization status and appropriate antibiotic therapy for nosocomial bacteremia caused by antibiotic-resistant gram-negative bacteria in an intensive care unit. Infect Control Hosp Epidemiol. 2005. https://doi.org/10.1086/502575.CrossRefPubMed

17.

Donskey CJ. The role of the intestinal tract as a reservoir and source for transmission of nosocomial pathogens. Clin Infect Dis. 2004. https://doi.org/10.1086/422002.CrossRefPubMed

18.

Averbuch D, Orasch C, Cordonnier C, Livermore DM, Mikulska M, Viscoli C, et al. European guidelines for empirical antibacterial therapy for febrile neutropenic patients in the era of growing resistance: summary of the 2011 4th European conference on infections in leukemia. Haematologica. 2013. https://doi.org/10.3324/haematol.2013.091025.CrossRefPubMedPubMedCentral

19.

Bassetti M, Righi E. Multidrug-resistant bacteria: what is the threat? Hematol Am Soc Hematol Educ Program. 2013. https://doi.org/10.1182/asheducation-2013.1.428.CrossRef

20.

Magarifuchi H, Hamada Y, Oho M, Kusaba K, Urakami T, Aoki Y. Clinical utility of direct application of matrix-assisted laser desorption ionization time-of-flight mass spectrometry and rapid disk diffusion test in presumptive antimicrobial therapy for bacteremia. J Infect Chemother. 2018. https://doi.org/10.1016/j.jiac.2018.07.014.CrossRefPubMed

21.

Trecarichi EM, Cauda R, Tumbarello M. Detecting risk and predicting patient mortality in patients with extended-spectrum beta-lactamase-producing Enterobacteriaceae bloodstream infections. Future Microbiol. 2012. https://doi.org/10.2217/fmb.12.100.CrossRefPubMed

22.

Hattori T, Nishiyama H, Ikegami S, Minoshima M, Kato H, Yuasa N. Clinical evaluation of FAPlus/FNPlus bottles compared with the combination of SA/SN and FA/FN bottles in the BacT/Alert blood culture system. J Med Invest. 2020. https://doi.org/10.2152/jmi.67.90.CrossRefPubMed

23.

Kanda Y. Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant. 2013. https://doi.org/10.1038/bmt.2012.244.CrossRefPubMedPubMedCentral

24.

JANIS Open Report. https://janis.mhlw.go.jp/english/report/index.html (2021). Accessed 16 November 2021.

25.

Jans B, Schoevaerdts D, Huang TD, Berhin C, Latour K, Bogaerts P, et al. Epidemiology of multidrug-resistant microorganisms among nursing home residents in Belgium. PLoS ONE. 2013. https://doi.org/10.1371/journal.pone.0064908.CrossRefPubMedPubMedCentral

26.

van Schaik W. The human gut resistome. Philos Trans R Soc Lond B Biol Sci. 2015. https://doi.org/10.1098/rstb.2014.0087.CrossRefPubMedPubMedCentral

27.

Bellm LA, Epstein JB, Rose-Ped A, Martin P, Fuchs HJ. Patient reports of complications of bone marrow transplantation. Support Care Cancer. 2000. https://doi.org/10.1007/s005209900095.CrossRefPubMed

28.

Keefe DM, Schubert MM, Elting LS, Sonis ST, Epstein JB, Raber-Durlacher JE, et al. Updated clinical practice guidelines for the prevention and treatment of mucositis. Cancer. 2007. https://doi.org/10.1002/cncr.22484.CrossRefPubMed

29.

Nesher L, Rolston KV. The current spectrum of infection in cancer patients with chemotherapy related neutropenia. Infection. 2014. https://doi.org/10.1007/s15010-013-0525-9.CrossRefPubMed

30.

Wingard JR, Hsu J, Hiemenz JW. Hematopoietic stem cell transplantation: an overview of infection risks and epidemiology. Infect Dis Clin North Am. 2010. https://doi.org/10.1016/j.idc.2010.01.010.CrossRefPubMed

31.

Yan ST, Sun LC, Jia HB, Gao W, Yang JP, Zhang GQ. Procalcitonin levels in bloodstream infections caused by different sources and species of bacteria. Am J Emerg Med. 2017. https://doi.org/10.1016/j.ajem.2016.12.017.CrossRefPubMed

32.

Soga Y, Maeda Y, Ishimaru F, Tanimoto M, Maeda H, Nishimura F, et al. Bacterial substitution of coagulase-negative staphylococci for streptococci on the oral mucosa after hematopoietic cell transplantation. Support Care Cancer. 2011. https://doi.org/10.1007/s00520-010-0923-9.CrossRefPubMed

33.

Saito R, Koyano S, Nagai R, Okamura N, Moriya K, Koike K. Evaluation of a chromogenic agar medium for the detection of extended-spectrum β-lactamase-producing Enterobacteriaceae. Lett Appl Microbiol. 2010. https://doi.org/10.1111/j.1472-765x.2010.02945.x.CrossRefPubMed

34.

Japanese Society of Medical Oncology. Practical Guideline for Febrile Neutropenia (FN). 2nd ed. Tokyo, Japan: Nankodo Co Ltd; 2017.

35.

Trecarichi EM, Pagano L, Candoni A, Pastore D, Cattaneo C, Fanci R, et al. Current epidemiology and antimicrobial resistance data for bacterial bloodstream infections in patients with hematologic malignancies: an Italian multicentre prospective survey. Clin Microbiol Infect. 2015. https://doi.org/10.1016/j.cmi.2014.11.022.CrossRefPubMed

Titel: Predictive value of surveillance cultures for bacteremia caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales among patients with hematological diseases
verfasst von: Takuya Hattori
Tatsunori Goto
Masahide Osaki
Yukiyasu Ozawa
Koichi Miyamura
Publikationsdatum: 10.01.2022
Verlag: Springer Berlin Heidelberg
Erschienen in: Infection / Ausgabe 3/2022
Print ISSN: 0300-8126
Elektronische ISSN: 1439-0973
DOI: https://doi.org/10.1007/s15010-021-01753-z

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Predictive value of surveillance cultures for bacteremia caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales among patients with hematological diseases