Nosocomial infections due to multidrug-resistant bacteria in cancer patients: a six-year retrospective study of an oncology Center in Western China
Abstract Background Bacterial infections are the most frequent complications in patients with malignancy, and the epidemiology of nosocomial infections among cancer patients has changed over time. This study aimed to evaluate the characteristics, antibiotic resistance patterns, and prognosis of noso...
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | http://link.springer.com/article/10.1186/s12879-020-05181-6 |
| _version_ | 1818257852560572416 |
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| author | Ai-Min Jiang Xin Shi Na Liu Huan Gao Meng-Di Ren Xiao-Qiang Zheng Xiao Fu Xuan Liang Zhi-Ping Ruan Yu Yao Tao Tian |
| author_facet | Ai-Min Jiang Xin Shi Na Liu Huan Gao Meng-Di Ren Xiao-Qiang Zheng Xiao Fu Xuan Liang Zhi-Ping Ruan Yu Yao Tao Tian |
| author_sort | Ai-Min Jiang |
| collection | DOAJ |
| description | Abstract Background Bacterial infections are the most frequent complications in patients with malignancy, and the epidemiology of nosocomial infections among cancer patients has changed over time. This study aimed to evaluate the characteristics, antibiotic resistance patterns, and prognosis of nosocomial infections due to multidrug-resistant (MDR) bacteria in cancer patients. Methods This retrospective observational study analyzed cancer patients with nosocomial infections caused by MDR from August 2013 to May 2019. The extracted clinical data were recorded in a standardized form and compared based on the survival status of the patients after infection and during hospitalization. The data were analyzed using independent samples t-test, Chi-square test, and binary logistic regression. P-values < 0.05 were considered significant. Results One thousand eight patients developed nosocomial infections during hospitalization, with MDR strains detected in 257 patients. Urinary tract infection (38.1%), respiratory tract infection (26.8%), and bloodstream infection (BSI) (12.5%) were the most common infection types. Extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL-PE) (72.8%) members were the most frequently isolated MDR strains, followed by Acinetobacter baumannii (11.7%), and Stenotrophomonas maltophilia (6.2%). The results of multivariate regression analysis revealed that smoking history, intrapleural/abdominal infusion history within 30 days, the presence of an indwelling urinary catheter, length of hospitalization, and hemoglobin were independent factors for in-hospital mortality in the study population. The isolated MDR bacteria exhibited high rates of sensitivity to amikacin, meropenem, and imipenem. Conclusions The burden of nosocomial infections due to MDR bacteria is considerably high in oncological patients, with ESBL-PE being the most predominant causative pathogen. Our findings suggest that amikacin and carbapenems actively against more than 89.7% of MDR isolates. The precise management of MDR bacterial infections in cancer patients may improve the prognosis of these individuals. |
| first_indexed | 2024-12-12T17:50:14Z |
| format | Article |
| id | doaj.art-64eb3cfda2864410bb340b3f659e588e |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-12T17:50:14Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-64eb3cfda2864410bb340b3f659e588e2022-12-22T00:16:49ZengBMCBMC Infectious Diseases1471-23342020-06-0120111210.1186/s12879-020-05181-6Nosocomial infections due to multidrug-resistant bacteria in cancer patients: a six-year retrospective study of an oncology Center in Western ChinaAi-Min Jiang0Xin Shi1Na Liu2Huan Gao3Meng-Di Ren4Xiao-Qiang Zheng5Xiao Fu6Xuan Liang7Zhi-Ping Ruan8Yu Yao9Tao Tian10Department of Medical Oncology, The First Affiliated Hospital of Xi’an Jiaotong UniversitySchool of Public Health, Xi’an Jiaotong University Health Science CenterDepartment of Medical Oncology, The First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Medical Oncology, The First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Medical Oncology, The First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Medical Oncology, The First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Medical Oncology, The First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Medical Oncology, The First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Medical Oncology, The First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Medical Oncology, The First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Medical Oncology, The First Affiliated Hospital of Xi’an Jiaotong UniversityAbstract Background Bacterial infections are the most frequent complications in patients with malignancy, and the epidemiology of nosocomial infections among cancer patients has changed over time. This study aimed to evaluate the characteristics, antibiotic resistance patterns, and prognosis of nosocomial infections due to multidrug-resistant (MDR) bacteria in cancer patients. Methods This retrospective observational study analyzed cancer patients with nosocomial infections caused by MDR from August 2013 to May 2019. The extracted clinical data were recorded in a standardized form and compared based on the survival status of the patients after infection and during hospitalization. The data were analyzed using independent samples t-test, Chi-square test, and binary logistic regression. P-values < 0.05 were considered significant. Results One thousand eight patients developed nosocomial infections during hospitalization, with MDR strains detected in 257 patients. Urinary tract infection (38.1%), respiratory tract infection (26.8%), and bloodstream infection (BSI) (12.5%) were the most common infection types. Extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL-PE) (72.8%) members were the most frequently isolated MDR strains, followed by Acinetobacter baumannii (11.7%), and Stenotrophomonas maltophilia (6.2%). The results of multivariate regression analysis revealed that smoking history, intrapleural/abdominal infusion history within 30 days, the presence of an indwelling urinary catheter, length of hospitalization, and hemoglobin were independent factors for in-hospital mortality in the study population. The isolated MDR bacteria exhibited high rates of sensitivity to amikacin, meropenem, and imipenem. Conclusions The burden of nosocomial infections due to MDR bacteria is considerably high in oncological patients, with ESBL-PE being the most predominant causative pathogen. Our findings suggest that amikacin and carbapenems actively against more than 89.7% of MDR isolates. The precise management of MDR bacterial infections in cancer patients may improve the prognosis of these individuals.http://link.springer.com/article/10.1186/s12879-020-05181-6Cancer patientsNosocomial infectionsMultidrug-resistant bacteriaRisk factors |
| spellingShingle | Ai-Min Jiang Xin Shi Na Liu Huan Gao Meng-Di Ren Xiao-Qiang Zheng Xiao Fu Xuan Liang Zhi-Ping Ruan Yu Yao Tao Tian Nosocomial infections due to multidrug-resistant bacteria in cancer patients: a six-year retrospective study of an oncology Center in Western China BMC Infectious Diseases Cancer patients Nosocomial infections Multidrug-resistant bacteria Risk factors |
| title | Nosocomial infections due to multidrug-resistant bacteria in cancer patients: a six-year retrospective study of an oncology Center in Western China |
| title_full | Nosocomial infections due to multidrug-resistant bacteria in cancer patients: a six-year retrospective study of an oncology Center in Western China |
| title_fullStr | Nosocomial infections due to multidrug-resistant bacteria in cancer patients: a six-year retrospective study of an oncology Center in Western China |
| title_full_unstemmed | Nosocomial infections due to multidrug-resistant bacteria in cancer patients: a six-year retrospective study of an oncology Center in Western China |
| title_short | Nosocomial infections due to multidrug-resistant bacteria in cancer patients: a six-year retrospective study of an oncology Center in Western China |
| title_sort | nosocomial infections due to multidrug resistant bacteria in cancer patients a six year retrospective study of an oncology center in western china |
| topic | Cancer patients Nosocomial infections Multidrug-resistant bacteria Risk factors |
| url | http://link.springer.com/article/10.1186/s12879-020-05181-6 |
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