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Predictive value of surveillance cultures for bacteremia caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales among patients with hematological diseases

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Abstract

Purpose

Due to the increasing prevalence of extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales, empirical therapies with cefepime or piperacillin/tazobactam for hematology patients with febrile neutropenia have become ineffective. Carbapenems should be administered as soon as possible in such patients with ESBL bacteremia. If the surveillance culture results are consistent with the blood culture findings, the time to adequate treatment initiation can be shortened.

Methods

All consecutive patients with Enterobacterales bacteraemia who were admitted from January 2013 to December 2018 at the hematology wards were enrolled in this study. Surveillance rectal swab and blood culture results were compared.

Results

In total, 67 patients with Enterobacterales bacteremia underwent surveillance culture prior to the onset of infection. Regarding the presence or absence of ESBL-producing Enterobacterales, 64 (95.5%) patients had surveillance results concordant with blood culture results. The positive predictive value of surveillance culture for bacteremia caused by ESBL-producing Enterobacterales was 95.0%. Moreover, the negative predictive value of surveillance culture for bacteremia caused by non-ESBL-producing Enterobacterales was 95.7%.

Conclusion

The concordance rate between the surveillance rectal swab and blood cultures was highly acceptable. Surveillance rectal swab cultures are useful for identifying patients at high risk for ESBL bacteremia.

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Data availability

Anonymized data are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Funding

This research was funded by Japanese Red Cross, Nagoya 1st Hospital Research Grant (NFRCH 20–0023).

Author information

Authors and Affiliations

  1. Department of Clinical Laboratory, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan

    Takuya Hattori

  2. Department of Hematology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan

    Tatsunori Goto, Masahide Osaki, Yukiyasu Ozawa & Koichi Miyamura

Authors
  1. Takuya Hattori
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  2. Tatsunori Goto
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  3. Masahide Osaki
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  4. Yukiyasu Ozawa
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  5. Koichi Miyamura
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Contributions

TH designed the study, collected data, performed the statistical analysis, and drafted the original manuscript. TG and MO interpreted data and revised the manuscript. YO and KM supervised the study. All authors have approved the final manuscript.

Corresponding author

Correspondence to Takuya Hattori.

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Conflict of interest

We declare no conflict of interest relevant to this study.

Ethics approval

This study was approved by the Ethical Committee of Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital (2019-099).

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Hattori, T., Goto, T., Osaki, M. et al. Predictive value of surveillance cultures for bacteremia caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales among patients with hematological diseases. Infection 50, 753–759 (2022). https://doi.org/10.1007/s15010-021-01753-z

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  • DOI: https://doi.org/10.1007/s15010-021-01753-z

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