Risk factors for extended-spectrum beta-lactamase-producing Enterobacteriales infection: are they the same in neutropenic and non-neutropenic patients?
- 4 Downloads
Febrile neutropenia (FN) is one of the most frequent and serious complications of chemotherapy for cancer. Neutropenia is defined by an abnormal reduction of neutrophils usually within 7–12 days after chemotherapy. According to the European Society for Medical Oncology (ESMO), FN is defined as “an oral temperature of > 38.3 °C or two consecutive readings of > 38.0 °C for 2 h and an absolute neutrophil count (ANC) of < 0.5 × 109/L, or expected to fall below 0.5 × 109/L” . Neutropenic patients may be less capable of fighting infections due to the reduced levels of neutrophils in circulation. In patients with FN, the prognosis is worst in case of proven bacteremia, with mortality rates of 18% in Gram-negative and 5% in Gram-positive bacteremia . During the last decade, the global increase in the prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriales has also affected immunocompromised patients . ESBLs can hydrolyze many beta-lactams except for...
Compliance with ethical standards
Conflict of interest
The authors state that they have no conflicts of interest.
Statements on human and animal rights
The article does not contain any studies with human participants or animals performed by the author.
- 3.Trecarichi EM, Tumbarello M, Spanu T et al (2009) Incidence and clinical impact of extended-spectrum-β-lactamase (ESBL) production and fluoroquinolone resistance in bloodstream infections caused by Escherichia coli in patients with hematological malignancies. J Infect 58:299–307. https://doi.org/10.1016/j.jinf.2009.02.002 CrossRefGoogle Scholar
- 4.Rottier WC, Ammerlaan HSM, Bonten MJM (2012) Effects of confounders and intermediates on the association of bacteraemia caused by extended-spectrum β-lactamase-producing enterobacteriaceae and patient outcome: a meta-analysis. J Antimicrob Chemother 67:1311–1320. https://doi.org/10.1093/jac/dks065 CrossRefGoogle Scholar
- 6.Harris PNA, Tambyah PA, Lye DC et al (2018) Effect of piperacillin-tazobactam vs meropenem on 30-day mortality for patients with E. coli or Klebsiella pneumoniae bloodstream infection and ceftriaxone resistance. JAMA J Am Med Assoc 320:984–994. https://doi.org/10.1001/jama.2018.12163 CrossRefGoogle Scholar
- 7.Barlam TF, Cosgrove SE, Abbo LM et al (2016) Executive summary: Implementing an antibiotic stewardship program: guidelines by the infectious diseases society of America and the society for healthcare epidemiology of America. Clin Infect Dis 62:1197–1202. https://doi.org/10.1093/cid/ciw217 CrossRefGoogle Scholar
- 11.Ben-Chetrit E, El Dahim MA, Bar-Meir M et al (2018) Associated factors and clinical outcomes of bloodstream infection due to extended-spectrum β-lactamase producing Escherichia coli and Klebsiella pneumoniae during febrile neutropenia. Int J Antimicrob Agents. https://doi.org/10.1016/j.ijantimicag.2018.12.003 Google Scholar
- 13.Castanheira M, Farrell SE, Krause KM et al (2014) Contemporary diversity of β-lactamases among enterobacteriaceae in the nine U.S. census regions and ceftazidime–avibactam activity tested against isolates producing the most prevalent β-lactamase groups. Antimicrob Agents Chemother 58:833–838. https://doi.org/10.1128/AAC.01896-13 CrossRefGoogle Scholar
- 17.Scheuerman O, Schechner V, Carmeli Y et al (2018) Comparison of predictors and mortality between bloodstream infections caused by ESBL-producing Escherichia coli and ESBL-producing Klebsiella pneumoniae. Infect Control Hosp Epidemiol 39:660–667. https://doi.org/10.1017/ice.2018.63 CrossRefGoogle Scholar