Aim. To study the risk factors, symptoms and outcomes of candidemia caused by C. albicans and C. non - albicans in patients with hematological malignancies. Materials and methods. The study included patients with hematological malignancies and candidemia. The diagnosis of candidemia was established according to the single isolation of Candida spp. from blood culture and the presence of symptoms of infection. Results and discussion. Over 12 years (2006-2017), candidemia was diagnosed in 75 patients aged 17 to 77 years (median 48 years). The causative agents of candidemia were C. albicans in 34.7% of patients, C. non - albicans - in 65.3%. Candidemia caused by C. albicans prevailed in patients of the older age group (median 56.5 years, p=0.04) and in patients with lymphoma (61.5%, p=0.01) with colonization of the gut by the same species of Candida (88.5%, p=0.002). Isolation of C. non - albicans from blood culture was more common in patients with acute leukemia (51%, p=0.01) and in recipients of allogeneic hematopoietic stem cells (22.5%, p=0.01). The ability to form biofilms was observed more frequently among C. non - albicans (59.2%) than C. albicans (19.2%, p=0.001). The clinical symptoms of candidemia were non - specific (fever was in 97%). Septic shock developed in 25 (33%) patients with comparable frequency in both groups. Concomitant infections was also comparable (73% vs. 73.5%). Overall 30-day survival in patients with candidemia caused by C. albicans and C. non - albicans was 61.2% and 61.5%. Treatment with echinocandin was associated with increase of survival compared to other antifungal agents among patients with C. albicans candidaemia (88.9% versus 40%, p=0.02) and among C. non - albicans (77.3% versus 47.8%). Conclusion. C. non - albicans constituted a high proportion among causative agents of candidemia. High mortality rate was observed in both groups. Initial therapy with echinocandin was associated with increase of survival.

Objective: to evaluate the genetic relatedness of extended-spectrum β-lactamase (ESBL) producing Escherichia coli isolated from the gut in patients with acute myeloid leukemia and lymphoma at admission and during chemotherapy cycles. Materials and methods. The prospective study (2013–2014) included 73 patients (median age 39 years) with acute myeloid leukemia (n = 25) and lymphoma (n = 48). The follow-up period lasted for 96 days. ESBL-producing E. coli isolated from the gut were included in this study. ESBL-production was confirmed by phenotypic tests, blaCTX-M and blaTEM genes were detected by polymerase chain reaction, and genotyping was performed by ERIC (Enterobacterial Repetitive Intergenic Consensus) polymerase chain reaction. Results. ESBL-producing E. coli were detected in 39 (53 %) of 73 patients: of them 12 (16 %) patients were colonized at admission and 27 (37 %) patients – during chemotherapy cycles. Gene blaCTX-M was detected in 67 % of E. coli, blaTEM – in 41 %, both genes – in 26 %. There was no genetically related ESBL-producing E. coli among 12 isolates detected at admission. Genetic relatedness was detected in 16 (59 %) of 27 isolates obtained during a hospital stay. Genetically related ESBL-producing E. coli were isolated from patients hospitalized in the same and different departments, these isolates were characterized by the presence of both identical and various determinants of resistance. Conclusion. Our data demonstrated the possibility of patient-to-patient transmission of ESBL-producing E. coli isolated from the gut during a hospital stay.

Mortality rates approaching 60 % have been reported in hematological patients with infections caused by carbapenemase-producing Enterobacterales. The incidence of these infections is rapidly increasing, whereas the therapeutic options are limited. This review represents characteristics of infections caused by carbapenemase-producing Enterobacterales in patients with hematological disorders, highlights risk factors and management options of these infections.