Life-threatening Escherichia coli cellulitis in patients with haematological malignancies

Sunder, Shyam; Haguenoer, Eve; Bouvet, Delphine; Lissandre, Séverine; Brée, Annie; Perrotin, D.; Helloin, Emmanuelle; Lanotte, Philippe; Schouler, Catherine; Guillon, Antoine

doi:10.1099/jmm.0.042366-0

Cited by 11 publications

(9 citation statements)

References 18 publications

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“…E. coli is an uncommon but recognised cause of soft tissue infections in the immunocompromised. It has been reported in solid organ transplant recipients1 patients with haematological malignancies2 on haemodialysis3 and with cirrhosis 4. It is also well recognised in children with nephrotic syndrome 5…”

Section: Discussionmentioning

confidence: 99%

Multidrug-resistantEscherichia colisoft tissue infection investigated with bacterial whole genome sequencing

et al. 2014

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A 45-year-old man with dilated cardiomyopathy presented with acute leg pain and erythema suggestive of necrotising fasciitis. Initial surgical exploration revealed no necrosis and treatment for a soft tissue infection was started. Blood and tissue cultures unexpectedly grew a Gram-negative bacillus, subsequently identified by an automated broth microdilution phenotyping system as an extended-spectrum β-lactamase producingEscherichia coli. The patient was treated with a 3-week course of antibiotics (ertapenem followed by ciprofloxacin) and debridement for small areas of necrosis, followed by skin grafting. The presence ofE. colitriggered investigation of both host and pathogen. The patient was found to have previously undiagnosed liver disease, a risk factor forE. colisoft tissue infection. Whole genome sequencing of isolates from all specimens confirmed they were clonal, of sequence type ST131 and associated with a likely plasmid-associated AmpC (CMY-2), several other resistance genes and a number of virulence factors.

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Section: Discussionmentioning

confidence: 99%

Multidrug-resistantEscherichia colisoft tissue infection investigated with bacterial whole genome sequencing

et al. 2014

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“…Secondary bloodstream infections that originated from the digestive tract may also occur. However, the number of cases that have been previously reported was limited, and all of them were found to have occurred in immunocompromised patients [22].…”

Section: Discussionmentioning

confidence: 99%

Cancer patients with neutropenic septic shock: etiology and antimicrobial resistance

Jung

Kim

Ryoo

et al. 2020

Korean J Intern Med

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Background/Aims: Among patients with febrile neutropenia that developed after chemotherapy, high-risk patients, such as those having clinical instability or Multinational Association of Supportive Care in Cancer score of < 21, require hospitalization for intravenous empiric antibiotic therapy. Monotherapy with an anti-pseudomonal ß-lactam agent is recommended. Although many studies reported the microbial etiology of infections and resistant patterns of febrile neutropenia, the patients were not well characterized as having neutropenic septic shock. Therefore, this study aimed to determine the microbial spectrum of infections and resistance patterns of their isolates in patients with chemotherapy-induced neutropenic septic shock. Methods: Data of adult patients diagnosed with neutropenic septic shock in the emergency department between June 2012 and December 2016 were extracted from a prospectively compiled septic shock registry at a single academic medical center. Thereafter, microbiological studies and antimicrobial susceptibility tests were conducted. Results: In total, 109 bacteria were found in patients with neutropenic septic shock. Gram-negative bacteria were the predominant causative organisms (84, 77.1%). Moreover, 33 microorganisms (30.3%) were multidrug-resistant (MDR) bacteria with extended-spectrum β-lactamase-producing Escherichia coli (17, 50%) being the commonest. The most commonly affected sites in patients with MDR bacterial infections were the gastrointestinal tract (45%) and unknown (43.5%). Approximately 48.5% of MDR bacteria were resistant to cefepime but not to piperacillin-tazobactam or carbapenem. Conclusions: MDR bacteria were prevalent in patients with chemotherapy-induced neutropenic septic shock. Therefore, piperacillin-tazobactam or carbapenem may be considered as empiric antibiotics if MDR bacteria are suspected to be causative agents.

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“…Nowadays, general infections caused by E. coli are of the important problems in patients with hematological malignancies, especially after chemotherapy, which is usually followed by bad prognoses (5). Cellulitis and different types of soft tissue infections caused by E. coli, are rare and usually need background risk factors such as reduced number or dysfunction of neutrophils (6).…”

Section: Discussionmentioning

confidence: 99%

“…Cellulitis and different types of soft tissue infections caused by E. coli, are rare and usually need background risk factors such as reduced number or dysfunction of neutrophils (6). The first E. coliinduced Ecthyma gangrenosum was reported in 1979 in a 1year-old baby with cellulitis on the left nostril without bacteremia and E. coli was isolated from the lesion and the nose (2,5). (Table 1) (2).…”

Section: Discussionmentioning

confidence: 99%

Ecthyma gangrenosum Due to Escherichia coli Bacteremia in a Patient with Acute Myeloid Leukemia: A Case Report and a Literature Review About E. coli-Induced Ecthyma gangrenosum

Salehi

Sharifian

Almasian

et al. 2019

Arch Clin Infect Dis

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Introduction: Ecthyma gangrenosum is a skin lesion presenting invasive infection in the skin, which is commonly caused by Pseudomonas. Pathogenesis is mostly attributed to the microbial invasion in cutaneous tissues caused by the microorganism. One of the important, but rare causes of Ecthyma gangrenosum after Pseudomonas is Escherichia coli. Case Presentation: A 45-year-old woman known as a case with acute myeloid leukemia who went into remission due to chemotherapy. After chemotherapy, she was febrile and septic. A physical examination revealed an erythematous round lesion (3 × 3 cm) that had developed on the posterior aspect of the right thigh with central bolus necrosis. E. coli was detected based on both blood cultures. Conclusions: Ecthyma gangrenosum is mostly seen in patients with severe immunodeficiency such as aplastic anemia, hematologic malignancies, especially patients with leukemia after chemotherapy and also in HIV patients. So far, in 11 patients reported in the literature, at least 8 cases are reported lesions on the lower limb, which is the most probable anatomic area for E. coli-induced Ecthyma gangrenosum. The E. coli-induced Ecthyma gangrenosum is a rare infectious lesion that is particularly seen in patients with a malignancy history, and lower extremity lesions should be considered.

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Life-threatening Escherichia coli cellulitis in patients with haematological malignancies

Cited by 11 publications

References 18 publications

Multidrug-resistantEscherichia colisoft tissue infection investigated with bacterial whole genome sequencing

Multidrug-resistantEscherichia colisoft tissue infection investigated with bacterial whole genome sequencing

Cancer patients with neutropenic septic shock: etiology and antimicrobial resistance

Ecthyma gangrenosum Due to Escherichia coli Bacteremia in a Patient with Acute Myeloid Leukemia: A Case Report and a Literature Review About E. coli-Induced Ecthyma gangrenosum

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