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. 2016 Fall-Winter;1(2):234-242.
doi: 10.20411/pai.v1i2.115.

Increasing Rates of Fluoroquinolone Resistance in Escherichia coli Isolated From the Blood and Urine of Patients with Hematologic Malignancies and Stem Cell Transplant Recipients

Christopher G Hauck  1 , Pearlie P Chong  1 , Melissa B Miller  2 , Katarzyna Jamieson  3 , Jason P Fine  4 , Matthew C Foster  3 , Thomas C Shea  3 , David van Duin  1
Affiliations

Increasing Rates of Fluoroquinolone Resistance in Escherichia coli Isolated From the Blood and Urine of Patients with Hematologic Malignancies and Stem Cell Transplant Recipients

Christopher G Hauck et al. Pathog Immun. 2016 Fall-Winter.

Abstract

Fluoroquinolone (FQ) antibiotics have been shown to reduce mortality and the number of febrile episodes when used as prophylaxis during neutropenia. Prior studies suggest that prophylaxis may result in increasing rates of FQ resistance. Fluoroquinolone non-susceptibility trends in Escherichia coli isolated from blood and urine cultures were evaluated over a 16-year period during which prophylaxis was initiated in patients with hematologic malignancies and stem cell transplants. Non-susceptibility rates increased after the introduction of prophylaxis, with yearly non-susceptibility rates rising from 30%-33% to 40%-88% in blood isolates. The high rates of non-susceptibility now observed raise concerns about the continued efficacy of FQ prophylaxis. This concern exists particularly in those patients undergoing stem cell transplants where the total FQ non-susceptibility rates over the study period were 82.3%. Further evaluation of the effect of FQ prophylaxis on antibiotic resistance and its efficacy in the setting of increased rates of resistance is warranted.

Keywords: Escherichia coli; Fluoroquinolone resistance; hematologic malignancy; stem cell transplant.

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Figures

Figure 1.
Figure 1.
Trend in fluoroquinolone non-susceptibility rates in first E. coli positive blood culture by year of occurrence, 2000-2015. The error bars represent 95% confidence intervals. HSCT, hematopoietic stem cell transplant. Abbreviations: HSCT, hematopoietic stem cell transplant.
Figure 2.
Figure 2.
Trend in fluoroquinolone non-susceptibility rates in the first E. coli positive urine culture by year of occurrence, 2000-2013. The error bars represent 95% confidence intervals. Abbreviations: HSCT, hematopoietic stem cell transplant.
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