Evaluation of Fecal Colonization with Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae and Risk Factors among Cancer Patients in Eastern Iran

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.

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Prevalence of and risk factors for extended-spectrum beta-lactamase genes carriership in a population-based cohort of middle-aged and elderly

International Journal of Antimicrobial Agents ◽

10.1016/j.ijantimicag.2021.106388 ◽

2021 ◽

pp. 106388

Author(s):

M. Mulder ◽

P.P. Arp ◽

J.C. Kiefte-de Jong ◽

A.G. Uitterlinden ◽

C.H.W. Klaassen ◽

...

Keyword(s):

Risk Factors ◽

Population Based ◽

Beta Lactamase ◽

Middle Aged ◽

Extended Spectrum Beta Lactamase ◽

Extended Spectrum

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Bacteremia Caused by Escherichia coli producing Extended-spectrum Beta-lactamase: a Case-control Study of Risk Factors and Outcomes

Scandinavian Journal of Infectious Diseases ◽

10.1080/00365540210147516 ◽

2002 ◽

Vol 34 (8) ◽

pp. 567-573 ◽

Cited By ~ 76

Author(s):

Pak-Leung Ho ◽

Wai-Ming Chan ◽

Samson S. Y. Wong ◽

Karl Young ◽

Kenneth W. T. Tsang

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Case Control Study ◽

Case Control ◽

Beta Lactamase ◽

Extended Spectrum Beta Lactamase ◽

Extended Spectrum ◽

Control Study

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A retrospective analysis of risk factors and outcomes in patients with extended-spectrum beta-lactamase-producing Escherichia coli bloodstream infections

Journal of Global Antimicrobial Resistance ◽

10.1016/j.jgar.2018.12.014 ◽

2019 ◽

Vol 17 ◽

pp. 147-156 ◽

Cited By ~ 5

Author(s):

Tingting Xiao ◽

Zhenzhu Wu ◽

Qingyi Shi ◽

Xiaoli Zhang ◽

Yanzi Zhou ◽

...

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Retrospective Analysis ◽

Bloodstream Infections ◽

Beta Lactamase ◽

Extended Spectrum Beta Lactamase ◽

Extended Spectrum

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Molecular detection and antibiotic resistance pattern of extended-spectrum beta-lactamase producing Escherichia coli in a Tertiary Hospital in Enugu, Nigeria

Annals of Clinical Microbiology and Antimicrobials ◽

10.1186/s12941-019-0342-9 ◽

2019 ◽

Vol 18 (1) ◽

Cited By ~ 1

Author(s):

Ifeyinwa N. Nwafia ◽

Martin E. Ohanu ◽

Samuel O. Ebede ◽

Uchenna C. Ozumba

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Intensive Care Unit ◽

Intensive Care ◽

Intensive Care Unit Admission ◽

Beta Lactamase ◽

Extended Spectrum Beta Lactamase ◽

E Coli ◽

Extended Spectrum ◽

Associated Risk Factors

Abstract Background The use of antibiotic agents in the treatment of infectious diseases has greatly contributed to the decrease in morbidity and mortality, but these great advances in treatment are being undermined by the rapidly increasing antimicrobial resistant organisms. Extended-spectrum beta-lactamases are enzymes hydrolyzing the beta lactam antibiotics, including third generation cephalosporins and monobactams but not cephamycins and carbapenems. They pose a serious global health threat and have become a challenge for health care providers. The aim of this research was to assess the prevalence of extended-spectrum beta-lactamase producing Escherichia coli in University of Nigeria Teaching Hospital Ituku-Ozalla Enugu and to detect the risk factors for acquisition of the resistant organism. To proffer advice on antibiotic stewardship in clinical practice and public health interventions, to curb the spread of the resistant organisms in the hospital. Results Out of the 200 E. coli isolates, 70 (35.00%) were confirmed positive for extended-spectrum beta-lactamase production. Fifty-three (75.7%) were from hospital acquired infections. All the isolates were resistant to ampicillin, tetracycline and chloramphenicol while 68 (97.14%) of the 70 isolates were susceptible to imipenem. BlaTEM, blaSHV and blaTEM were detected in 66 (94%) of the 70 isolates. The ESBL bla genes detected were blaCTX-M (n = 26; 37.14%), blaTEM (n = 7; 10.00%), blaSHV (n = 2; 2.86%), blaCTX-M/TEM (n = 7; 10.0%), blaCTX-M/SHV (n = 14; 20.0%) and blaCTX-M/TEM/SHV (n = 10; 14.29%). The three bla genes were not detected in 4 (5.71%) of the isolates. Recent surgery, previous antibiotic and intensive care unit admission were the associated risk factors to infections caused by extended-spectrum beta-lactamase producing E. coli. Conclusion There is a high rate of infections caused by extended-spectrum beta-lactamase producing E. coli. Recent surgery, previous antibiotic and intensive care unit admission were associated risk factors.

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