Clinical outcome of Escherichia coli bloodstream infection in cancer patients with/without biofilm formation: a single-center retrospective study

被引：17

作者：

Zhang, Qing ^{[1
]}

Gao, Hao-Yang ^{[2
]}

Li, Ding ^{[1
]}

Li, Zheng ^{[1
]}

Qi, Shan-Shan ^{[3
]}

Zheng, Shan ^{[1
]}

Bai, Chang-Sen ^{[1
]}

Zhang, Si-He ^{[3
]}

机构：

[1] Tianjin Med Univ, Canc Inst & Hosp, Tianjins Clin Res Ctr Canc,Med Lab Dept, Key Lab Canc Prevent & Therapy,Natl Clin Res Ctr, Tianjin, Peoples R China

[2] Gansu Univ Chinese Med, Affiliated Hosp, Med Lab Dept, Lanzhou, Gansu, Peoples R China

[3] Nankai Univ, Sch Med, Dept Cell Biol, 94 Weijin Rd, Tianjin 300071, Peoples R China

来源：

INFECTION AND DRUG RESISTANCE | 2019年 / 12卷

基金：

中国国家自然科学基金;

关键词：

biofilm formation; extended-spectrum beta-lactamase; Escherichia coli; blood-stream infection; BETA-LACTAMASE PRODUCTION; KLEBSIELLA-PNEUMONIAE; CTX-M; MOLECULAR EPIDEMIOLOGY; PREVALENCE; RESISTANCE; GENES; ENTEROBACTERIACEAE; BACTEREMIA; MORTALITY;

D O I：

10.2147/IDR.S192072

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Background: Extended-spectrum 13-lactamase-producing Escherichia coli (ESBL-EC) is one of the main antimicrobial-resistant pathogens. Little data are available on how biofilm formation (BF) contributes to EC-caused bloodstream infection (BSI) in cancer patients. This study investigated the impact of BF on clinical outcomes of cancer patients with EC-caused BSI. Methods: Clinical outcome and microbiological characteristics including the presence of hula genes in ESBL-EC isolates were retrospectively collected from BSI cancer patients. Patients infected with ESBL-EC were compared with patients infected with third-generation cephalosporin-susceptible strains. Survival curves were generated by Kaplan-Meier analysis and the survival difference was assessed by the log-rank test. Risk factors for ESBL-EC infection, predictors of mortality, and outcome differences were determined by multivariate logistic regression and Cox regression analysis, respectively. Results: A high prevalence of ESBL-EC with dominant bla(ctx-m-15) bla(ctx-m-15) plus bla(TEM-52) genotype was found in BSI cancer patients. Independent risk factors for infection with ESBL-EC were cephalosporins, chemotherapy, and BE Metastasis, ICU admission, BF-positive ESBLEC, organ failure, and the presence of septic shock were revealed as predictors for mortality. The ESBL characteristic was associated with the BF phenotype, and the overall mortality was significantly higher in cancer patients with BF-positive ESBL-EC-caused BSI. Condusion: bla(CTM-M-15) type ESBL-EC is highly endemic among cancer patients with BSI. BF is associated with multi-drug resistance by ESBL-EC and is also an independent risk factor of mortality for cancer patients with BSI. Our findings suggest that the combination of BF-positive ESBL-EC isolates with other appropriate laboratory indicators might benefit infection control and improve clinical outcomes.

引用

页码：359 / 371

页数：13

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