Bibliographic Details
| Title: |
Bacteremia in Patients with Solid Organ Cancer: Insights into Epidemiology and Antibiotic Consumption. |
| Authors: |
de Dios-García, Begoña, Maestro, Guillermo, Díaz-Pedroche, Carmen, Parra, Wagner, Campos, Óscar, Orellana, María Ángeles, Caro, José Manuel, Lumbreras, Carlos, Lizasoain, Manuel |
| Source: |
Cancers; Dec2023, Vol. 15 Issue 23, p5561, 10p |
| Subject Terms: |
ANTIBIOTICS, BACTEREMIA, CATHETER-related infections, RESEARCH methodology, RETROSPECTIVE studies, ACQUISITION of data, FLUOROQUINOLONES, MEDICAL records, TUMORS, DRUG resistance in microorganisms |
| Abstract: |
Simple Summary: Prior knowledge of local epidemiology is useful to optimize antibiotic prescription. Solid organ cancer patients (SOC) are frequently prescribed antibiotics, as we confirmed in our retrospective study. Our aim was to describe risk factors for bacterial resistance in SOC patients with bacteremia in order to determine the adequacy of antibiotic treatment, improve outcomes, and diminish the emergence of bacterial resistance. We compared the rates of bacterial resistance in oncology and medical wards, as well as antibiotic consumption. We observed that resistance rates in worrisome bacteria were not higher in the oncology ward than in medical wards. Furthermore, consumption of broad-spectrum antibiotics was reduced, in which hospital co-management with the internal medicine department may have played a role. The presence of a urinary catheter and previous antibiotic consumption were risk factors for bacterial resistance. Epidemiology and risk factors associated to bacterial resistance in solid organ cancer (SOC) patients has been barely described. This retrospective monocentric study analyzed clinical variables in SOC patients who developed bacteremia between 1 January 2019 and 31 December 2022. We described rates of bacterial resistance in Gram negative bacteria (80.6%): E. coli-ESBL, K. pneumoniae-ESBL, Carbapenem-Resistant K. pneumoniae and Meropenem-Resistant P. aeruginosa, as well as antibiotic consumption, and compared these rates between the medical and oncology wards. In total, we included 314 bacteremias from 253 patients. SOC patients are frequently prescribed antibiotics (40.8%), mainly fluoroquinolones. Nosocomial bacteremia accounted for 18.2% of the cases and only 14.3% of patients were neutropenic. Hepatobiliary tract was the most frequent tumor (31.5%) and source of bacteremia (38.5%). Resistant bacteria showed a decreased rate of resistance during the years studied in the oncology ward. Both K-ESBL and K-CBP resistance rates decreased (from 45.8% to 20.0%, and from 29.2% to 20.0%, respectively), as well as MRPA, which varied from a resistance rate of 28% to 16.7%. The presence of a urinary catheter (p < 0.001) and previous antibiotic prescription (p = 0.002) were risk factors for bacterial resistance. Identifying either of these risk factors could help in guiding antibiotic prescription for SOC patients. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
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