Antimicrobial Resistance in Gram-Negative Rods Causing Bacteremia in Hematopoietic Stem Cell Transplant Recipients: Intercontinental Prospective Study of the Infectious Diseases Working Party of the European Bone Marrow Transplantation Group

Averbuch, Diana; Tridello, Gloria; Hoek, Jennifer; Mikulska, Małgorzata; Akan, Hamdı; Segundo, Lucrecia Yáñez San; Pabst, Thomas; Özçelik, Tülay; Klyasova, Galina; Donnini, Irene; Wu, Depei; Gülbaş, Zafer; Zuckerman, Tsila; Sousa, Aïda Botelho de; Béguin, Yves; Xhaard, Aliénor; Bachy, Emmanuel; Ljungman, Per; Cámara, Rafael de la; Rascon, Jelena; Ruiz‐Camps, Isabel; Vı́tek, Antonı́n; Patriarca, Francesca; Cudillo, Laura; Vrhovać, Radovan; Shaw, Peter J.; Wolfs, Tom F. W.; O’Brien, Tracey; Avni, Batia; Silling, Gerda; Sabty, Firas Al; Graphakos, Stelios; Sankelo, Marja; Sengeloev, Henrik; Pillai, Srinivas; Matthes, Susanne; Melanthiou, Frederiki; Iacobelli, Simona; Styczyński, Jan; Engelhard, Dan; Cesaro, Simone

doi:10.1093/cid/cix646

Cited by 211 publications

(161 citation statements)

References 35 publications

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“…CRE isolates also showed high susceptibility to tigecycline (89.7%) [17]. It should be noted that tigecycline resistance rate of Klebsiella pneumoniae in hematopoietic stem cell transplant patients can reach 16% [18]. Taken together, we inferred that tigecycline exposure increased the risk of CRE BSI might due to intestinal ora disorder.…”

Section: Discussionmentioning

confidence: 63%

Construction of a risk prediction model for subsequent bloodstream infection in intestinal carriers of carbapenem-resistant Enterobacteriaceae: a retrospective study in hematology department and intensive care unit

Wang

Lin

Chen

et al. 2020

Preprint

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Background To establish a risk prediction model for carbapenem-resistant Enterobacteriaceae (CRE) bloodstream infection (BSI) in intestinal carriers. Methods CRE screenings were performed every two weeks in hematology department and intensive care unit (ICU). Patients with positive CRE rectal swab screening were identified using electronic healthcare records from 15 May 2018 to 31 December 2019. All CRE strains were collected and identified. Carriers who developed CRE BSI were compared with those who did not develop CRE infection. The control group 1:1 stratified randomly matched the case group. Univariate logistic analysis, multivariate logistic analysis and stepwise regression analysis were carried out. Results A total of 42 cases were included. Multivariate analysis showed that gastrointestinal injury (OR 86.82, 95%CI 2.58-2916.59, P = 0.013), tigecycline exposure (OR 14.99, 95%CI 1.82-123.74 P = 0.012) and carbapenem resistance score (OR 11.24, 95% CI 1.81–69.70, P = 0.009) were independent risk factors for CRE BSI in intestinal carriers (P < 0.05). They were included in the Logistic regression model to predict BSI. According to receiver operating characteristic (ROC) curve analysis, the cut-off value of the model was 0.72, and the sensitivity, specificity and area under the curve (AUC) were 90.5%, 85.7% and 0.92, respectively. Conclusions The risk prediction model based on gastrointestinal injury, tigecycline exposure and carbapenem resistance score of colonizing strain can effectively predict CRE BSI in patients with CRE colonization. Early CRE screening and detection for inpatients in key departments may early warning and reduce the risk of nosocomial infection of CRE.

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Section: Discussionmentioning

confidence: 63%

Construction of a risk prediction model for subsequent bloodstream infection in intestinal carriers of carbapenem-resistant Enterobacteriaceae: a retrospective study in hematology department and intensive care unit

Wang

Lin

Chen

et al. 2020

Preprint

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“…The unfolding of multidrug resistance has become a prominent health issue worldwide and may be seen as of great preoccupation, especially in individuals with onco-haematological diseases with febrile neutropenia [8,9,24,26,27]. We witnessed a high proportion of MDR isolates, predominantly ESBL-producing E. coli and K. pneumoniae, and MDR P. aeruginosa.…”

Section: Discussionmentioning

confidence: 99%

“…Crude mortality rates range from 12% to 42%, and attributable mortality rates have been reported as reaching a high of 30%; both of which make immediate empirical antibiotic therapy mandatory in these patients [2e7]. An empirical antibiotic approach is challenging during a time of cumulative antibiotic resistance, and inappropriate antibiotic therapy for multidrug-resistant (MDR) Gram-negative bacilli (GNB) has been related with greater mortality [8,9]. Consequently, broadspectrum antibiotics and even combination therapies are usually endorsed in this population, in spite of most patients not having a documented infection [10,11].…”

Section: Introductionmentioning

confidence: 99%

Current time-to-positivity of blood cultures in febrile neutropenia: a tool to be used in stewardship de-escalation strategies

Puerta‐Alcalde

Cardozo

Suárez‐Lledó

et al. 2019

Clinical Microbiology and Infection

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“…79 IIAT of serious GNB infections is associated with increased mortality and has been the rationale for using broad-spectrum antibiotics upfront in critically ill patients. 32,46,[91][92][93] RDTs along with ASPs have been particularly effective in improving outcomes for these infections. 80 A study from Methodist hospital in Houston integrated RDTs with ASP for the management of gramnegative bacteremia.…”

Section: Evidence In Support Of the Use Of Rdts To Optimize Antibiotimentioning

confidence: 99%

Novel Approaches to Hasten Detection of Pathogens and Antimicrobial Resistance in the Intensive Care Unit

Guillamet

Burnham

Kollef

2019

Semin Respir Crit Care Med

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Antibiotic resistance is recognized as a key determinant of outcome in patients with serious infections influencing empiric antibiotic practices especially for critically ill patients. Within the intensive care unit (ICU), nosocomial infections and increasingly community-onset infections are caused by multidrug-resistant bacteria. Escalating rates of antibiotic resistance adds substantially to the morbidity, mortality, and cost related to infections treated in the ICU. Both gram-positive organisms, such as methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci, and gram-negative bacteria, including Pseudomonas aeruginosa, Acinetobacter species, carbapenem-resistant Enterobacteriaceae, and extended spectrum β-lactamase producing organisms, are urgent threats. The rising rates of antimicrobial resistance have resulted in routine empiric administration of broad-spectrum antibiotics by clinicians to critically ill patients even when bacterial infection is microbiologically absent. Moreover, new broad-spectrum antibiotics are a challenge to use effectively while avoiding emergence of further resistance. Use of rapid diagnostic technologies (RDTs) will likely provide an important methodology for achieving this important balance. There is an urgent need for integrating the administration of new and existing antibiotics with RDTs in a way that is safe, cost-effective, applicable in all countries, and sustainable.

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Antimicrobial Resistance in Gram-Negative Rods Causing Bacteremia in Hematopoietic Stem Cell Transplant Recipients: Intercontinental Prospective Study of the Infectious Diseases Working Party of the European Bone Marrow Transplantation Group

Abstract: Background

Cited by 211 publications

References 35 publications

Construction of a risk prediction model for subsequent bloodstream infection in intestinal carriers of carbapenem-resistant Enterobacteriaceae: a retrospective study in hematology department and intensive care unit

Construction of a risk prediction model for subsequent bloodstream infection in intestinal carriers of carbapenem-resistant Enterobacteriaceae: a retrospective study in hematology department and intensive care unit

Current time-to-positivity of blood cultures in febrile neutropenia: a tool to be used in stewardship de-escalation strategies

Novel Approaches to Hasten Detection of Pathogens and Antimicrobial Resistance in the Intensive Care Unit

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