Abstract
Multiresistant bacterial infections are a potentially life-threatening condition in acute leukaemia (AL) patients. We aimed to better define the very recent epidemiology and outcome of bloodstream infections (BSIs) in a real-life setting. We prospectively collected all consecutive febrile/infectious episodes occurring in AL patients admitted to 9 haematology units. In 293 AL patients, 433 BSIs were diagnosed. Gram-positive (GP) bacteria were isolated in 44.8 % BSI and Gram-negative (GN) in 38.3 %, while polymicrobial aetiology- or fungi-related events were identified in 15.7 and 1.1 % of the cases, respectively. GP was observed more frequently in patients not in complete remission (p = 0.04), while GN during consolidation cycles (p = 0.003). Extended spectrum β-lactamase-producing strains accounted for 23.2 % of enterobacteria. They were associated with previous antibiotic exposure, including fluoroquinolones prophylaxis (p = 0.01). Carbapenem-resistant (CR) strains occurred in 9 % of enterobacteria. Among Pseudomonas aeruginosa strains, 21.6 % were multiresistant. Overall 30-day mortality was 8.5 %. CR GN and multiresistant P. aeruginosa BSIs were independent predictors of death (p = 0.002), as well as relapsed/resistant AL (18.3 %; p = 0.0002) and the presence of pulmonary infiltrates (26.6 %; p < 0.001). Although GP still predominate over GN BSI, the percentage of antibiotic resistant GN strains is considerable in AL patients and it is associated with poor prognosis.
| Original language | English |
|---|---|
| Pages (from-to) | 1955-1963 |
| Number of pages | 9 |
| Journal | Annals of Hematology |
| Volume | 95 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - Dec 1 2016 |
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Keywords
- Acute leukaemia
- Bloodstream infections
- Fluoroquinolone prophylaxis
- Multiresistant bacteria
ASJC Scopus subject areas
- Hematology
Cite this
Emerging resistant bacteria strains in bloodstream infections of acute leukaemia patients : results of a prospective study by the Rete Ematologica Lombarda (Rel). / Cattaneo, Chiara; Zappasodi, Patrizia; Mancini, Valentina; Annaloro, Claudio; Pavesi, Francesca; Skert, Cristina; Ferrario, A.; Todisco, Elisabetta; Saccà, V.; Verga, L.; Passi, A.; Da Vià, Matteo C.; Ferrari, Samantha; Mometto, G.; Petullà, M.; Nosari, Annamaria; Rossi, Giuseppe.
In: Annals of Hematology, Vol. 95, No. 12, 01.12.2016, p. 1955-1963.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Emerging resistant bacteria strains in bloodstream infections of acute leukaemia patients
T2 - results of a prospective study by the Rete Ematologica Lombarda (Rel)
AU - Cattaneo, Chiara
AU - Zappasodi, Patrizia
AU - Mancini, Valentina
AU - Annaloro, Claudio
AU - Pavesi, Francesca
AU - Skert, Cristina
AU - Ferrario, A.
AU - Todisco, Elisabetta
AU - Saccà, V.
AU - Verga, L.
AU - Passi, A.
AU - Da Vià, Matteo C.
AU - Ferrari, Samantha
AU - Mometto, G.
AU - Petullà, M.
AU - Nosari, Annamaria
AU - Rossi, Giuseppe
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Multiresistant bacterial infections are a potentially life-threatening condition in acute leukaemia (AL) patients. We aimed to better define the very recent epidemiology and outcome of bloodstream infections (BSIs) in a real-life setting. We prospectively collected all consecutive febrile/infectious episodes occurring in AL patients admitted to 9 haematology units. In 293 AL patients, 433 BSIs were diagnosed. Gram-positive (GP) bacteria were isolated in 44.8 % BSI and Gram-negative (GN) in 38.3 %, while polymicrobial aetiology- or fungi-related events were identified in 15.7 and 1.1 % of the cases, respectively. GP was observed more frequently in patients not in complete remission (p = 0.04), while GN during consolidation cycles (p = 0.003). Extended spectrum β-lactamase-producing strains accounted for 23.2 % of enterobacteria. They were associated with previous antibiotic exposure, including fluoroquinolones prophylaxis (p = 0.01). Carbapenem-resistant (CR) strains occurred in 9 % of enterobacteria. Among Pseudomonas aeruginosa strains, 21.6 % were multiresistant. Overall 30-day mortality was 8.5 %. CR GN and multiresistant P. aeruginosa BSIs were independent predictors of death (p = 0.002), as well as relapsed/resistant AL (18.3 %; p = 0.0002) and the presence of pulmonary infiltrates (26.6 %; p < 0.001). Although GP still predominate over GN BSI, the percentage of antibiotic resistant GN strains is considerable in AL patients and it is associated with poor prognosis.
AB - Multiresistant bacterial infections are a potentially life-threatening condition in acute leukaemia (AL) patients. We aimed to better define the very recent epidemiology and outcome of bloodstream infections (BSIs) in a real-life setting. We prospectively collected all consecutive febrile/infectious episodes occurring in AL patients admitted to 9 haematology units. In 293 AL patients, 433 BSIs were diagnosed. Gram-positive (GP) bacteria were isolated in 44.8 % BSI and Gram-negative (GN) in 38.3 %, while polymicrobial aetiology- or fungi-related events were identified in 15.7 and 1.1 % of the cases, respectively. GP was observed more frequently in patients not in complete remission (p = 0.04), while GN during consolidation cycles (p = 0.003). Extended spectrum β-lactamase-producing strains accounted for 23.2 % of enterobacteria. They were associated with previous antibiotic exposure, including fluoroquinolones prophylaxis (p = 0.01). Carbapenem-resistant (CR) strains occurred in 9 % of enterobacteria. Among Pseudomonas aeruginosa strains, 21.6 % were multiresistant. Overall 30-day mortality was 8.5 %. CR GN and multiresistant P. aeruginosa BSIs were independent predictors of death (p = 0.002), as well as relapsed/resistant AL (18.3 %; p = 0.0002) and the presence of pulmonary infiltrates (26.6 %; p < 0.001). Although GP still predominate over GN BSI, the percentage of antibiotic resistant GN strains is considerable in AL patients and it is associated with poor prognosis.
KW - Acute leukaemia
KW - Bloodstream infections
KW - Fluoroquinolone prophylaxis
KW - Multiresistant bacteria
UR - http://www.scopus.com/inward/record.url?scp=84988659895&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84988659895&partnerID=8YFLogxK
U2 - 10.1007/s00277-016-2815-7
DO - 10.1007/s00277-016-2815-7
M3 - Article
VL - 95
SP - 1955
EP - 1963
JO - Annals of Hematology
JF - Annals of Hematology
SN - 0939-5555
IS - 12
ER -