1. Clinical outcome of Escherichia coli bloodstream infection in cancer patients with/without biofilm formation: a single-center retrospective study
- Author
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Zhang,Qing, Gao,Hao-Yang, Li,Ding, Li,Zheng, Qi,Shan-Shan, Zheng,Shan, Bai,Chang-Sen, Zhang,Si-He, Zhang,Qing, Gao,Hao-Yang, Li,Ding, Li,Zheng, Qi,Shan-Shan, Zheng,Shan, Bai,Chang-Sen, and Zhang,Si-He
- Abstract
Qing Zhang,1 Hao-Yang Gao,2 Ding Li,1 Zheng Li,1 Shan-Shan Qi,3 Shan Zheng,1 Chang-Sen Bai,1 Si-He Zhang3 1Medical Laboratory Department, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China; 2Medical Laboratory Department, Affiliated Hospital of Gansu University of Chinese Medicine, Gansu, China; 3Department of Cell Biology, School of Medicine, Nankai University, Tianjin, China Background: Extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC) is one of the main antimicrobial-resistant pathogens. Little data are available on how biofilm formation (BF) contributes to EC-caused bloodstream infection (BSI) in cancer patients. This study investigated the impact of BF on clinical outcomes of cancer patients with EC-caused BSI.Methods: Clinical outcome and microbiological characteristics including the presence of bla genes in ESBL-EC isolates were retrospectively collected from BSI cancer patients. Patients infected with ESBL-EC were compared with patients infected with third-generation cephalosporin-susceptible strains. Survival curves were generated by Kaplan–Meier analysis and the survival difference was assessed by the log-rank test. Risk factors for ESBL-EC infection, predictors of mortality, and outcome differences were determined by multivariate logistic regression and Cox regression analysis, respectively.Results: A high prevalence of ESBL-EC with dominant blaCTX-M-15, blaCTX-M-15 plus blaTEM-52 genotype was found in BSI cancer patients. Independent risk factors for infection with ESBL-EC were cephalosporins, chemotherapy, and BF. Metastasis, ICU admission, BF-positive ESBL-EC, organ failure, and the presence of septic shock were revealed as predictors for mortality. The ESBL characteristic was associated with the BF phenotype, and the overall mortality was signif
- Published
- 2019