Risk factors for resistant gram-positive bacteremia in febrile neutropenic patients with cancer
Copyright © 2024 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved..
BACKGROUND: Gram-positive bacteria are frequently resistant to empirical beta-lactams in febrile neutropenic patients with cancer. As microbiology and antibiotic susceptibility changes, we reevaluated the risk factors for resistant Gram-positive bacteremia in febrile neutropenic patients with cancer.
METHODS: Episodes of bacteremic febrile neutropenia in Seoul National University Hospital from July 2019 to June 2022 were reviewed. Resistant Gram-positive bacteria were defined as a pathogen susceptible only to glycopeptide or linezolid in vitro (e.g., methicillin-resistant staphylococci, penicillin-resistant viridans streptococci, and ampicillin-resistant enterococci). Episodes were compared to identify independent risk factors for resistant Gram-positive bacteremia.
RESULTS: Of 225 episodes, 78 (34.7%) involved resistant Gram-positive bacteremia. Multivariate analysis revealed that breakthrough bacteremia while being administered antibiotics (adjusted odds ratio [aOR], 6.794; 95% confidence interval [95% CI], 3.130-14.749; P < 0.001) and catheter-related infection (aOR 4.039, 95% CI 1.366-11.946; P = 0.012) were associated with resistant Gram-positive bacteremia. Chronic liver disease (aOR 0.231, 95% CI 0.059-0.905; P = 0.035) and hypotension at bacteremia (aOR 0.454, 95% CI 0.218-0.945; P = 0.035) were inversely associated with resistant Gram-positive bacteremia.
CONCLUSIONS: Resistant Gram-positive bacteria should be considered in breakthrough bacteremia and catheter-related infection in febrile neutropenic patients with cancer.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy - (2024) vom: 20. März |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lee, Minkyeong [VerfasserIn] |
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| Links: |
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| Themen: |
Bacteremia |
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| Anmerkungen: |
Date Revised 23.03.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1016/j.jiac.2024.03.013 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM370084136 |
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| 520 | |a Copyright © 2024 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND: Gram-positive bacteria are frequently resistant to empirical beta-lactams in febrile neutropenic patients with cancer. As microbiology and antibiotic susceptibility changes, we reevaluated the risk factors for resistant Gram-positive bacteremia in febrile neutropenic patients with cancer | ||
| 520 | |a METHODS: Episodes of bacteremic febrile neutropenia in Seoul National University Hospital from July 2019 to June 2022 were reviewed. Resistant Gram-positive bacteria were defined as a pathogen susceptible only to glycopeptide or linezolid in vitro (e.g., methicillin-resistant staphylococci, penicillin-resistant viridans streptococci, and ampicillin-resistant enterococci). Episodes were compared to identify independent risk factors for resistant Gram-positive bacteremia | ||
| 520 | |a RESULTS: Of 225 episodes, 78 (34.7%) involved resistant Gram-positive bacteremia. Multivariate analysis revealed that breakthrough bacteremia while being administered antibiotics (adjusted odds ratio [aOR], 6.794; 95% confidence interval [95% CI], 3.130-14.749; P < 0.001) and catheter-related infection (aOR 4.039, 95% CI 1.366-11.946; P = 0.012) were associated with resistant Gram-positive bacteremia. Chronic liver disease (aOR 0.231, 95% CI 0.059-0.905; P = 0.035) and hypotension at bacteremia (aOR 0.454, 95% CI 0.218-0.945; P = 0.035) were inversely associated with resistant Gram-positive bacteremia | ||
| 520 | |a CONCLUSIONS: Resistant Gram-positive bacteria should be considered in breakthrough bacteremia and catheter-related infection in febrile neutropenic patients with cancer | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Bacteremia | |
| 650 | 4 | |a Cancer | |
| 650 | 4 | |a Febrile neutropenia | |
| 650 | 4 | |a Gram-positive bacteria | |
| 650 | 4 | |a Resistance | |
| 700 | 1 | |a Lee, Chan Mi |e verfasserin |4 aut | |
| 700 | 1 | |a Byun, Ja Min |e verfasserin |4 aut | |
| 700 | 1 | |a Shin, Dong-Yeop |e verfasserin |4 aut | |
| 700 | 1 | |a Koh, Youngil |e verfasserin |4 aut | |
| 700 | 1 | |a Hong, Junshik |e verfasserin |4 aut | |
| 700 | 1 | |a Choe, Pyoeng Gyun |e verfasserin |4 aut | |
| 700 | 1 | |a Park, Wan Beom |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Nam Joong |e verfasserin |4 aut | |
| 700 | 1 | |a Yoon, Sung-Soo |e verfasserin |4 aut | |
| 700 | 1 | |a Oh, Myoung-Don |e verfasserin |4 aut | |
| 700 | 1 | |a Kang, Chang Kyung |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Inho |e verfasserin |4 aut | |
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