Risk factors for bloodstream infections due to extended-spectrum β-lactamase producing Enterobacteriaceae in cancer patients

  • Sabahat Ceken Dr Abdurrahman Yurtaslan Oncology Research and Training Hospital, Ankara, Turkey
  • Gulsen Iskender Dr Abdurrahman Yurtaslan Oncology Research and Training Hospital, Ankara, Turkey
  • Habip Gedik Bakırkör Sadi Konuk Research and Training Hospital, Istanbul, Turkey
  • Fazilet Duygu Dr Abdurrahman Yurtaslan Oncology Research and Training Hospital, Ankara, Turkey
  • Duygu Mert Dr Abdurrahman Yurtaslan Oncology Research and Training Hospital, Ankara, Turkey
  • Ali Hakan Kaya Dr Abdurrahman Yurtaslan Oncology Research and Training Hospital, Ankara, Turkey
  • Fevzi Altuntas Dr Abdurrahman Yurtaslan Oncology Research and Training Hospital, Ankara, Turkey
  • Mustafa Ertek Dr Abdurrahman Yurtaslan Oncology Research and Training Hospital, Ankara, Turkey
Keywords: Extended Spectrum Beta-Lactamase, ESBL, Enterobacteriaceae, cancer, risk factors

Abstract

Introduction: Bloodstream infection (BSI) caused by Enterobacteriaceae is associated with mortality in cancer patients receiving chemotherapy. The aim of this study is to identify the risk factors and outcomes related to BSIs caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae in cancer patients.

Methodology: Hematology/oncology patients, who were diagnosed with BSIs caused by Enterobacteriaceae by positive blood cultures were evaluated retrospectively. Patients were divided into two groups by ESBL-positive and ESBL-negative Enterobacteriaceae bacteremia. Patients' demographic features, underlying conditions, comorbidity, neutrophil count, duration of neutropenia, antibiotic use in the previous three months before infection, mechanical ventilation, steroid use, central venous catheter implementation, total parenteral nutrition (TPN), hospitalization in the past three months, stay in intensive care unit, quinolone prophylaxis, and history of infection with ESBL-producing Enterobactericeae were evaluated. Risk factors related to BSIs caused by ESBL-producing Enterobacteriaceae and mortality were assessed.

Results: A total of 122 patients were evaluated retrospectively. Quinolone propyhlaxis, TPN, infection with Extended Spectrum Beta-Lactamase positive ESBL-P Enterobacteriaceae during the previous three months, treatment with piperasillin-tazobactam or carbapenems in the previous three months were found to be independent risk factors for ESBL-P BSIs. Longer duration of neutropenia before BSI and complication at the beginning of BSI were found to be independent risk factors for mortality related to infection.

Conclusions: ESBL-producing Enterobacteriacea should be treated with an appropriate antibiotic that is associated with better outcomes in hematology/oncology patients with BSIs. History of broad-spectrum antibiotic use and stay in hospital in the previous three months should be taken into consideration upon commencing antibiotic therapy.

Author Biographies

Sabahat Ceken, Dr Abdurrahman Yurtaslan Oncology Research and Training Hospital, Ankara, Turkey

Department of Infectious Diseases and Clinical Microbiology

Gulsen Iskender, Dr Abdurrahman Yurtaslan Oncology Research and Training Hospital, Ankara, Turkey

Department of Infectious Diseases and Clinical Microbiology

Habip Gedik, Bakırkör Sadi Konuk Research and Training Hospital, Istanbul, Turkey

Department of Infectious Diseases and Clinical Microbiology

Fazilet Duygu, Dr Abdurrahman Yurtaslan Oncology Research and Training Hospital, Ankara, Turkey

Department of Infectious Diseases and Clinical Microbiology

Duygu Mert, Dr Abdurrahman Yurtaslan Oncology Research and Training Hospital, Ankara, Turkey

Department of Infectious Diseases and Clinical Microbiology

Ali Hakan Kaya, Dr Abdurrahman Yurtaslan Oncology Research and Training Hospital, Ankara, Turkey

Department of Hematology

Fevzi Altuntas, Dr Abdurrahman Yurtaslan Oncology Research and Training Hospital, Ankara, Turkey

Department of Hematology

Mustafa Ertek, Dr Abdurrahman Yurtaslan Oncology Research and Training Hospital, Ankara, Turkey

Department of Infectious Diseases and Clinical Microbiology

Published
2018-04-30
How to Cite
1.
Ceken S, Iskender G, Gedik H, Duygu F, Mert D, Kaya A, Altuntas F, Ertek M (2018) Risk factors for bloodstream infections due to extended-spectrum β-lactamase producing Enterobacteriaceae in cancer patients. J Infect Dev Ctries 12:265-272. doi: https://doi.org/10.3855/jidc.9720
Section
Original Articles