TY - JOUR
T1 - Bloodstream infections caused by Escherichia coli in onco-haematological patients: Risk factors and mortality in an Italian prospective survey
AU - Trecarichi, Enrico Maria
AU - Giuliano, Gabriele
AU - Cattaneo, Chiara
AU - Ballanti, Stelvio
AU - Criscuolo, Marianna
AU - Candoni, Anna
AU - Marchesi, Francesco
AU - Laurino, Marica
AU - Dargenio, Michelina
AU - Fanci, Rosa
AU - Cefalo, Mariagiovanna
AU - Delia, Mario
AU - Spolzino, Angelica
AU - Maracci, Laura
AU - Nadali, Gianpaolo
AU - Busca, Alessandro
AU - Del Principe, Maria Ilaria
AU - Daffini, Rosa
AU - Simonetti, Edoardo
AU - Dragonetti, Giulia
AU - Zannier, Maria Elena
AU - Pagano, Livio
AU - Tumbarello, Mario
PY - 2019
Y1 - 2019
N2 - Bloodstream infections (BSIs) remain life-threatening complications in the clinical course of patients with haematological malignancies (HM) and Escherichia coli represent one of the most frequent cause of such infections. In this study, we aimed to describe risk factors for resistance to third generation cephalosporins and prognostic factors, including the impact of third generation cephalosporins resistance, in patients with HM and BSIs caused by E. coli. Three hundred forty-two cases of E. coli BSIs were collected during the study period (from January 2016 to December 2017). The percentage of resistance to third generation cephalosporins was 25.7%. In multivariate analysis, the variables recent endoscopic procedures, culture-positive surveillance rectal swabs for multidrug-resistant bacteria, antibiotic prophylaxis with fluoroquinolones, and prolonged neutropenia were independently associated with bloodstream infections caused by a third generation cephalosporins resistant E. coli. The overall 30-day mortality rate was 7.1%. Cox regression revealed that significant predictors of mortality were acute hepatic failure, septic shock, male sex, refractory/relapsed HM, and third generation cephalosporins resistance by E. coli isolate. In conclusion, resistance to third generation cephalosporins adversely affected the outcomes of bloodstream infections caused by E. coli in our cohort of HM patients. We also found a significant correlation between prophylaxis with fluoroquinolones and resistance to third generation cephalosporins by E. coli isolates.
AB - Bloodstream infections (BSIs) remain life-threatening complications in the clinical course of patients with haematological malignancies (HM) and Escherichia coli represent one of the most frequent cause of such infections. In this study, we aimed to describe risk factors for resistance to third generation cephalosporins and prognostic factors, including the impact of third generation cephalosporins resistance, in patients with HM and BSIs caused by E. coli. Three hundred forty-two cases of E. coli BSIs were collected during the study period (from January 2016 to December 2017). The percentage of resistance to third generation cephalosporins was 25.7%. In multivariate analysis, the variables recent endoscopic procedures, culture-positive surveillance rectal swabs for multidrug-resistant bacteria, antibiotic prophylaxis with fluoroquinolones, and prolonged neutropenia were independently associated with bloodstream infections caused by a third generation cephalosporins resistant E. coli. The overall 30-day mortality rate was 7.1%. Cox regression revealed that significant predictors of mortality were acute hepatic failure, septic shock, male sex, refractory/relapsed HM, and third generation cephalosporins resistance by E. coli isolate. In conclusion, resistance to third generation cephalosporins adversely affected the outcomes of bloodstream infections caused by E. coli in our cohort of HM patients. We also found a significant correlation between prophylaxis with fluoroquinolones and resistance to third generation cephalosporins by E. coli isolates.
KW - bloodstream infection
KW - leukemia
KW - bloodstream infection
KW - leukemia
UR - http://hdl.handle.net/10807/143856
UR - https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0224465&type=printable
U2 - 10.1371/journal.pone.0224465
DO - 10.1371/journal.pone.0224465
M3 - Article
SN - 1932-6203
VL - 14
SP - e0224465-e0224473
JO - PLoS One
JF - PLoS One
ER -