scholarly journals Nosocomial Infections Due to Multidrug-Resistant Bacteria in Cancer Patients: A Seven-Year Experience of an Oncology Center in Western China

2020 ◽  
Author(s):  
Ai-Min Jiang ◽  
Xin Shi ◽  
Na Liu ◽  
Huan Gao ◽  
Meng-Di Ren ◽  
...  

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 characteristics, antibiotic-resistant patterns, and prognosis of nosocomial infections caused by multidrug-resistant bacteria (MDR) in cancer patients. Methods: This retrospectively analyzed cancer patients with MDR bacteria caused nosocomial infections from August 2013 to May 2019 and was conducted to explore the risk factors, clinical features, outcomes, and antibiotic-resistant patterns of these infections. Results: Overall, 257 cancer patients developed nosocomial infections caused by MDR bacteria. Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae was the most frequently isolated multidrug-resistant Gram-negative bacteria (MDRGNB), followed by ESBL-producing Klebsiella pneumonia, and Acinetobacter baumannii. Cancer patients with liver disease, received intrapleural/abdominal infusion within 30 days, length of hospitalization, hemoglobin, and albumin were independent factors for 30-day mortality in the study population. The isolated MDR bacteria were highly sensitive to amikacin, meropenem, imipenem, tigecycline, and piperacillin/tazobactam. Conclusions: Cancer patients with prolonged hospitalization was an independent predictor of a favorable outcome. However, cancer patients with liver disease, received intrapleural/abdominal infusion within 30 days, anemia, and hypoproteinemia were independent risk factors of 30-day mortality.

2020 ◽  
Author(s):  
Ai-Min Jiang ◽  
Xin Shi ◽  
Na Liu ◽  
Huan Gao ◽  
Meng-Di Ren ◽  
...  

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 characteristics, antibiotic-resistant patterns, and prognosis of nosocomial infections caused by multidrug-resistant (MDR) bacteria in cancer patients. Methods: This retrospective observational study analyzed cancer patients with MDR bacteria caused nosocomial infections from August 2013 to May 2019. The extracted clinical data were recorded in a standardized form and compared based on the patient’s survival status after infection during hospitalization. Data were analyzed by using independent samples t-test, Chi-square test, and binary logistic regression. P -values < 0.05 were considered statistically significant. Results: Overall, 257 cancer patients developed nosocomial infections caused by MDR bacteria. Extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL-PE) was the most frequently isolated multidrug-resistant Gram-negative bacteria (MDRGNB), followed by Acinetobacter baumannii , and Stenotrophomonas maltophilia . Smoking history, cancer patients who received intrapleural/abdominal infusion within 30 days, presence of indwelling urinary catheter, and haemoglobin were independent factors for in-hospital mortality in the study population. The isolated MDR bacteria were mainly sensitive to amikacin, meropenem, imipenem, tigecycline, and piperacillin/tazobactam. Conclusions: This study confirms that MDR bacteria caused nosocomial infections were widely prevalent in cancer patients. ESBL-PE was the most commonly MDR bacteria, and the isolated MDR strains were mainly sensitive to amikacin, meropenem, imipenem, tigecycline, and piperacillin/tazobactam. Former smokers, cancer patients who received intrapleural/abdominal infusion within 30 days, presence of indwelling urinary catheter, and anemia were associated with increased in-hospital mortality. Our findings suggest that clinicians should think highly of nosocomial infections caused by MDR in cancer patients and advise policymakers to develop a guideline.


2020 ◽  
Author(s):  
Ai-Min Jiang ◽  
Xin Shi ◽  
Na Liu ◽  
Huan Gao ◽  
Meng-Di Ren ◽  
...  

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 characteristics, antibiotic-resistant patterns, and prognosis of nosocomial infections caused by multidrug-resistant (MDR) bacteria in cancer patients. Methods: This retrospective observational study analyzed cancer patients with MDR bacteria caused nosocomial infections from August 2013 to May 2019. The extracted clinical data were recorded in a standardized form and compared based on the patient’s survival status after infection during hospitalization. Data were analyzed by using independent samples t-test, Chi-square test, and binary logistic regression. P -values < 0.05 were considered statistically significant. Results: Overall, 257 cancer patients developed nosocomial infections caused by MDR bacteria. Extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL-PE) was the most frequently isolated multidrug-resistant Gram-negative bacteria (MDRGNB), followed by Acinetobacter baumannii , and Stenotrophomonas maltophilia . Smoking history, cancer patients who received intrapleural/abdominal infusion within 30 days, presence of indwelling urinary catheter, length of hospitalization, and haemoglobin were independent factors for in-hospital mortality in the study population. The isolated MDR bacteria were mainly sensitive to amikacin, meropenem, imipenem, tigecycline, and piperacillin/tazobactam. Conclusions: Cancer patients with prolonged hospitalization was an independent predictor of a favorable outcome. However, former smokers, cancer patients who received intrapleural/abdominal infusion within 30 days, presence of indwelling urinary catheter, and anemia were independent risk factors of in-hospital mortality. Our findings suggest that clinicians should think highly of nosocomial infections caused by MDR in cancer patients and advise policymakers to develop a guideline.


2021 ◽  
Vol 9 (2) ◽  
pp. 354
Author(s):  
Nuria Crua Asensio ◽  
Javier Macho Rendón ◽  
Marc Torrent Burgas

The rise in the number of antibiotic-resistant bacteria has become a serious threat to health, making it important to identify, characterize and optimize new molecules to help us to overcome the infections they cause. It is well known that Acinetobacter baumannii has a significant capacity to evade the actions of antibacterial drugs, leading to its emergence as one of the bacteria responsible for hospital and community-acquired infections. Nonetheless, how this pathogen infects and survives inside the host cell is unclear. In this study, we analyze the time-resolved transcriptional profile changes observed in human epithelial HeLa cells after infection by A. baumannii, demonstrating how it survives in host cells and starts to replicate 4 h post infection. These findings were achieved by sequencing RNA to obtain a set of Differentially Expressed Genes (DEGs) to understand how bacteria alter the host cells’ environment for their own benefit. We also determine common features observed in this set of genes and identify the protein–protein networks that reveal highly-interacted proteins. The combination of these findings paves the way for the discovery of new antimicrobial candidates for the treatment of multidrug-resistant bacteria.


2021 ◽  
Vol 2021 ◽  
pp. 1-30
Author(s):  
Najwan Jubair ◽  
Mogana Rajagopal ◽  
Sasikala Chinnappan ◽  
Norhayati Binti Abdullah ◽  
Ayesha Fatima

Microbial resistance has progressed rapidly and is becoming the leading cause of death globally. The spread of antibiotic-resistant microorganisms has been a significant threat to the successful therapy against microbial infections. Scientists have become more concerned about the possibility of a return to the pre-antibiotic era. Thus, searching for alternatives to fight microorganisms has become a necessity. Some bacteria are naturally resistant to antibiotics, while others acquire resistance mainly by the misuse of antibiotics and the emergence of new resistant variants through mutation. Since ancient times, plants represent the leading source of drugs and alternative medicine for fighting against diseases. Plants are rich sources of valuable secondary metabolites, such as alkaloids, quinones, tannins, terpenoids, flavonoids, and polyphenols. Many studies focus on plant secondary metabolites as a potential source for antibiotic discovery. They have the required structural properties and can act by different mechanisms. This review analyses the antibiotic resistance strategies produced by multidrug-resistant bacteria and explores the phytochemicals from different classes with documented antimicrobial action against resistant bacteria, either alone or in combination with traditional antibiotics.


2019 ◽  
Vol 70 (1) ◽  
pp. e646-e647
Author(s):  
Maria Hernandez-Tejero ◽  
Fatima Aziz ◽  
Cristina Pitart ◽  
Francesc Marco Reverte ◽  
Irene Campo ◽  
...  

2020 ◽  
Vol 8 (9) ◽  
pp. 1425
Author(s):  
Lara Pérez-Etayo ◽  
David González ◽  
José Leiva ◽  
Ana Isabel Vitas

Due to the global progress of antimicrobial resistance, the World Health Organization (WHO) published the list of the antibiotic-resistant “priority pathogens” in order to promote research and development of new antibiotics to the families of bacteria that cause severe and often deadly infections. In the framework of the One Health approach, the surveillance of these pathogens in different environments should be implemented in order to analyze their spread and the potential risk of transmission of antibiotic resistances by food and water. Therefore, the objective of this work was to determine the presence of high and critical priority pathogens included in the aforementioned list in different aquatic environments in the POCTEFA area (North Spain–South France). In addition to these pathogens, detection of colistin-resistant Enterobacteriaceae was included due its relevance as being the antibiotic of choice to treat infections caused by multidrug resistant bacteria (MDR). From the total of 80 analyzed samples, 100% of the wastewater treatment plants (WWTPs) and collectors (from hospitals and slaughterhouses) and 96.4% of the rivers, carried antibiotic resistant bacteria (ARB) against the tested antibiotics. Fifty-five (17.7%) of the isolates were identified as target microorganisms (high and critical priority pathogens of WHO list) and 58.2% (n = 32) of them came from WWTPs and collectors. Phenotypic and genotypic characterization showed that 96.4% were MDR and resistance to penicillins/cephalosporins was the most widespread. The presence of bla genes, KPC-type carbapenemases, mcr-1 and vanB genes has been confirmed. In summary, the presence of clinically relevant MDR bacteria in the studied aquatic environments demonstrates the need to improve surveillance and treatments of wastewaters from slaughterhouses, hospitals and WWTPs, in order to minimize the dispersion of resistance through the effluents of these areas.


2019 ◽  
Vol 35 (1) ◽  
pp. 61-66
Author(s):  
Sunjukta Ahsan ◽  
Rayhan Mahmud ◽  
Kajal Ahsan ◽  
Shamima Begum

Infections due to Gram-negative bacteria are common affairs in cancer patients during aggressive therapy. The present study characterizedmulti-drug resistant bacteria (MDR) isolated from cancer aspirates collected from patients admitted to the National Cancer Hospital in Dhaka, Bangladesh. A total of 210 aspirate samples were collected from cancer patients. Out of 210 samples Acinetobacter spp.led the list of isolates (8.89%, n=45). Of these species, 50% exhibited resistance to Amoxycillin and Nitrofurantoin, each, 25% exhibited resistant to Cefotaxime, Azithromycin, Ciprofloxacin, Clindamycin, and Sulfamethoxazole. A total of 33.33% of the Bordetella spp.which accounted 6.67%of the total isolates exhibited resistance to Cefotaxime. All oftheLegionellapneumophila,comprising 4.4%of the isolated species, wereresistant to Cefotaxime, Azithromycin, and Clindamycin.In contrast, 50% were resistant to Cefotaxime, Azithromycin, and Ceftriaxone. Of the Escherichia coli(4.4%, n=45) isolated,50% exhibited resistance to Cefotaxime, Clindamycin, Ceftriaxone, Amoxycillinand Sulfamethoxazole.The only isolate of Klebsiella sp. was demonstrated to be an ESBL producer. The isolation of multidrug resistant bacteria from cancer patients is of particular concern in Bangladesh where cancer and drug resistance are both common phenomena but treatment facilities are poor. To our knowledge this is the first report of the isolation of drug resistant bacteria from cancer patients from Dhaka city. Bangladesh J Microbiol, Volume 35 Number 1 June 2018, pp 61-66


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