Epidemiology and emerging resistance in bacterial bloodstream infections in patients with hematologic malignancies


Kara O., Zarakolu P. , AŞÇIOĞLU HAYRAN S. , ETGÜL S. , Uz B., BÜYÜKAŞIK Y. , ...More

INFECTIOUS DISEASES, vol.47, no.10, pp.686-693, 2015 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 47 Issue: 10
  • Publication Date: 2015
  • Doi Number: 10.3109/23744235.2015.1051105
  • Title of Journal : INFECTIOUS DISEASES
  • Page Numbers: pp.686-693

Abstract

Background: The objective of this study was determine the frequency of bloodstream infections (BSIs) and the causative bacteria and their resistance patterns in patients with hematological malignancies (HMs) in a large tertiary care university hospital in Turkey over a 5-year period. Methods: A total of 2098 patients with HMs with 3703 neutropenic episodes were included. Patients were classifi ed as high-risk (n = 843) and low-risk (n = 1255) groups and evaluated for frequency of BSIs, causative bacteria, and their resistance patterns. Results: The frequency of BSIs was 14.5%. The frequency of gram-negative BSIs in high-risk and low-risk groups was 10.7% and 5.4% (p < 0.001), respectively. The frequency of gram-positive BSIs in high-risk and low-risk groups was 7.0% and 3.9% (p < 0.001), respectively. Gram-negative bacteria predominated (52.6%), with Escherichia coli (17.3%) and Klebsiella spp. (11.0%) as the most frequent organisms. Coagulase-negative staphylococci (10.4%) and Corynebacterium spp. (6.3%) were the most common gram-positive bacteria (35.8%). The rate of extended-spectrum beta-lactamase (ESBL) production was 45% for E. coli and 58% for Klebsiella spp. Quinolone resistance was 58% for E. coli and 11% for Klebsiella spp.. The overall frequency of ceftazidime resistance in Pseudomonas aeruginosa was 28%, and 87% of Acinetobacter spp. were multidrug-resistant. Of Staphylococcus aureus isolates, 24.8% were resistant to methicillin. Conclusion: The dominating causes of BSIs in patients with HMs in our hospital are resistant gramnegative bacteria, which has made empirical antimicrobial choice a highly challenging issue in this patient population.