1. Emerging resistant bacteria strains in bloodstream infections of acute leukaemia patients: results of a prospective study by the Rete Ematologica Lombarda (Rel).
- Author
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Cattaneo, Chiara, Zappasodi, P., Mancini, V., Annaloro, C., Pavesi, F., Skert, C., Ferrario, A., Todisco, E., Saccà, V., Verga, L., Passi, A., Da Vià, M., Ferrari, S., Mometto, G., Petullà, M., Nosari, A., Rossi, G., Saccà, V, Da Vià, M, and Petullà, M
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BACTERIAL diseases , *LEUKEMIA , *CHRONIC myeloid leukemia , *LONGITUDINAL method , *CARBAPENEMS , *GRAM-positive bacteria , *PATIENTS , *ANTIBIOTICS , *BACTEREMIA diagnosis , *DIAGNOSIS of bacterial diseases , *ACUTE myeloid leukemia diagnosis , *BACTEREMIA , *COMPARATIVE studies , *DRUG resistance in cancer cells , *DRUG resistance in microorganisms , *RESEARCH methodology , *MEDICAL cooperation , *PSEUDOMONAS , *RESEARCH , *EVALUATION research , *ACUTE myeloid leukemia , *BRIEF Symptom Inventory - 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. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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