Third generation cephalosporin resistant Enterobacteriaceae and multidrug resistant gram-negative bacteria causing bacteremia in febrile neutropenia adult cancer patients in Lebanon, broad spectrum antibiotics use as a major risk factor, and correlation with poor prognosis
Bacteremia remains a major cause of life-threatening complications in patients receiving anticancer chemotherapy. The spectrum and susceptibility profiles of causative microorganisms differ with time and place. Data from Lebanon are scarce. We aim at evaluating the epidemiology of bacteremia in canc...
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| Format: | Article |
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Frontiers Media S.A.
2015-02-01
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| Series: | Frontiers in Cellular and Infection Microbiology |
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| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fcimb.2015.00011/full |
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| author | Rima eMoghnieh Nour eEstaitieh Anas eMugharbil Tamima eJisr Dania Issam Abdallah Fouad eZiade Loubna eSinno Ahmad eIbrahim |
| author_facet | Rima eMoghnieh Nour eEstaitieh Anas eMugharbil Tamima eJisr Dania Issam Abdallah Fouad eZiade Loubna eSinno Ahmad eIbrahim |
| author_sort | Rima eMoghnieh |
| collection | DOAJ |
| description | Bacteremia remains a major cause of life-threatening complications in patients receiving anticancer chemotherapy. The spectrum and susceptibility profiles of causative microorganisms differ with time and place. Data from Lebanon are scarce. We aim at evaluating the epidemiology of bacteremia in cancer patients in a university hospital in Lebanon, emphasizing antibiotic resistance and risk factors of multi-drug resistant organism (MDRO)-associated bacteremia.This is a retrospective study of 75 episodes of bacteremia occurring in febrile neutropenic patients admitted to the hematology-oncology unit at Makassed General Hospital, Lebanon, from October 2009-January 2012.It corresponds to epidemiological data on bacteremia episodes in febrile neutropenic cancer patients including antimicrobial resistance and identification of risk factors associated with third generation cephalosporin resistance (3GCR) and MDRO-associated bacteremia. Out of 75 bacteremias, 42.7% were gram-positive (GP), and 57.3% were gram-negative (GN). GP bacteremias were mostly due to methicillin-resistant coagulase negative staphylococci (28% of total bacteremias and 66% of GP bacteremias). Among the GN bacteremias, Escherichia coli (22.7% of total, 39.5% of GN organisms) and Klebsiellapneumoniae(13.3% of total, 23.3% of GN organisms) were the most important causative agents. GN bacteremia due to 3GC sensitive (3GCS) bacteria represented 28% of total bacteremias, while 29% were due to 3GCR bacteria and 9% were due to carbapenem-resistant organisms. There was a significant correlation between bacteremia with MDRO and subsequent intubation, sepsis and mortality. Among potential risk factors, only broad spectrum antibiotic intake >4 days before bacteremia was found to be statistically significant for acquisition of 3GCR bacteria. Using carbapenems or piperacillin/ tazobactam>4 days before bacteremia was significantly associated with the emergence of MDRO (p value<0.05). |
| first_indexed | 2024-04-12T03:22:41Z |
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| id | doaj.art-1cf55c2c08bf41e4a1630fef59de1fe7 |
| institution | Directory Open Access Journal |
| issn | 2235-2988 |
| language | English |
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| publishDate | 2015-02-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Cellular and Infection Microbiology |
| spelling | doaj.art-1cf55c2c08bf41e4a1630fef59de1fe72022-12-22T03:49:51ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882015-02-01510.3389/fcimb.2015.00011126631Third generation cephalosporin resistant Enterobacteriaceae and multidrug resistant gram-negative bacteria causing bacteremia in febrile neutropenia adult cancer patients in Lebanon, broad spectrum antibiotics use as a major risk factor, and correlation with poor prognosisRima eMoghnieh0Nour eEstaitieh1Anas eMugharbil2Tamima eJisr3Dania Issam Abdallah4Fouad eZiade5Loubna eSinno6Ahmad eIbrahim7Makassed General HospitalMakassed General HospitalMakassed General HospitalMakassed General HospitalMakassed General HospitalLebanese UniversityMakassed General HospitalMakassed General HospitalBacteremia remains a major cause of life-threatening complications in patients receiving anticancer chemotherapy. The spectrum and susceptibility profiles of causative microorganisms differ with time and place. Data from Lebanon are scarce. We aim at evaluating the epidemiology of bacteremia in cancer patients in a university hospital in Lebanon, emphasizing antibiotic resistance and risk factors of multi-drug resistant organism (MDRO)-associated bacteremia.This is a retrospective study of 75 episodes of bacteremia occurring in febrile neutropenic patients admitted to the hematology-oncology unit at Makassed General Hospital, Lebanon, from October 2009-January 2012.It corresponds to epidemiological data on bacteremia episodes in febrile neutropenic cancer patients including antimicrobial resistance and identification of risk factors associated with third generation cephalosporin resistance (3GCR) and MDRO-associated bacteremia. Out of 75 bacteremias, 42.7% were gram-positive (GP), and 57.3% were gram-negative (GN). GP bacteremias were mostly due to methicillin-resistant coagulase negative staphylococci (28% of total bacteremias and 66% of GP bacteremias). Among the GN bacteremias, Escherichia coli (22.7% of total, 39.5% of GN organisms) and Klebsiellapneumoniae(13.3% of total, 23.3% of GN organisms) were the most important causative agents. GN bacteremia due to 3GC sensitive (3GCS) bacteria represented 28% of total bacteremias, while 29% were due to 3GCR bacteria and 9% were due to carbapenem-resistant organisms. There was a significant correlation between bacteremia with MDRO and subsequent intubation, sepsis and mortality. Among potential risk factors, only broad spectrum antibiotic intake >4 days before bacteremia was found to be statistically significant for acquisition of 3GCR bacteria. Using carbapenems or piperacillin/ tazobactam>4 days before bacteremia was significantly associated with the emergence of MDRO (p value<0.05).http://journal.frontiersin.org/Journal/10.3389/fcimb.2015.00011/fullBacteremiaLebanonFebrile neutropenia3GCR Gram-negative bacteriaMDR Gram-negative bacteria |
| spellingShingle | Rima eMoghnieh Nour eEstaitieh Anas eMugharbil Tamima eJisr Dania Issam Abdallah Fouad eZiade Loubna eSinno Ahmad eIbrahim Third generation cephalosporin resistant Enterobacteriaceae and multidrug resistant gram-negative bacteria causing bacteremia in febrile neutropenia adult cancer patients in Lebanon, broad spectrum antibiotics use as a major risk factor, and correlation with poor prognosis Frontiers in Cellular and Infection Microbiology Bacteremia Lebanon Febrile neutropenia 3GCR Gram-negative bacteria MDR Gram-negative bacteria |
| title | Third generation cephalosporin resistant Enterobacteriaceae and multidrug resistant gram-negative bacteria causing bacteremia in febrile neutropenia adult cancer patients in Lebanon, broad spectrum antibiotics use as a major risk factor, and correlation with poor prognosis |
| title_full | Third generation cephalosporin resistant Enterobacteriaceae and multidrug resistant gram-negative bacteria causing bacteremia in febrile neutropenia adult cancer patients in Lebanon, broad spectrum antibiotics use as a major risk factor, and correlation with poor prognosis |
| title_fullStr | Third generation cephalosporin resistant Enterobacteriaceae and multidrug resistant gram-negative bacteria causing bacteremia in febrile neutropenia adult cancer patients in Lebanon, broad spectrum antibiotics use as a major risk factor, and correlation with poor prognosis |
| title_full_unstemmed | Third generation cephalosporin resistant Enterobacteriaceae and multidrug resistant gram-negative bacteria causing bacteremia in febrile neutropenia adult cancer patients in Lebanon, broad spectrum antibiotics use as a major risk factor, and correlation with poor prognosis |
| title_short | Third generation cephalosporin resistant Enterobacteriaceae and multidrug resistant gram-negative bacteria causing bacteremia in febrile neutropenia adult cancer patients in Lebanon, broad spectrum antibiotics use as a major risk factor, and correlation with poor prognosis |
| title_sort | third generation cephalosporin resistant enterobacteriaceae and multidrug resistant gram negative bacteria causing bacteremia in febrile neutropenia adult cancer patients in lebanon broad spectrum antibiotics use as a major risk factor and correlation with poor prognosis |
| topic | Bacteremia Lebanon Febrile neutropenia 3GCR Gram-negative bacteria MDR Gram-negative bacteria |
| url | http://journal.frontiersin.org/Journal/10.3389/fcimb.2015.00011/full |
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