Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jan 31;11(2):359.
doi: 10.3390/microorganisms11020359.

Molecular and Clinical Data of Antimicrobial Resistance in Microorganisms Producing Bacteremia in a Multicentric Cohort of Patients with Cancer in a Latin American Country

Sergio Andrés Cruz-Vargas  1 , Laura García-Muñoz  1 , Sonia Isabel Cuervo-Maldonado  1   2   3 , Carlos Arturo Álvarez-Moreno  1   4 , Carlos Humberto Saavedra-Trujillo  1 , José Camilo Álvarez-Rodríguez  2   3   5 , Angélica Arango-Gutiérrez  2 , Julio César Gómez-Rincón  2 , Katherine García-Guzman  2 , Aura Lucía Leal  6 , Javier Garzón-Herazo  7 , Samuel Martínez-Vernaza  7   8 , Fredy Orlando Guevara  9 , Leydy Paola Jiménez-Cetina  10 , Liliana Marcela Mora  10 , Sandra Yamile Saavedra  6 , Jorge Alberto Cortés  1   11
Affiliations

Molecular and Clinical Data of Antimicrobial Resistance in Microorganisms Producing Bacteremia in a Multicentric Cohort of Patients with Cancer in a Latin American Country

Sergio Andrés Cruz-Vargas et al. Microorganisms. .

Abstract

Patients with cancer have a higher risk of severe bacterial infections. This study aims to determine the frequency, susceptibility profiles, and resistance genes of bacterial species involved in bacteremia, as well as risk factors associated with mortality in cancer patients in Colombia. In this prospective multicenter cohort study of adult patients with cancer and bacteremia, susceptibility testing was performed and selected resistance genes were identified. A multivariate regression analysis was carried out for the identification of risk factors for mortality. In 195 patients, 206 microorganisms were isolated. Gram-negative bacteria were more frequently found, in 142 cases (68.9%): 67 Escherichia coli (32.5%), 36 Klebsiella pneumoniae (17.4%), and 21 Pseudomonas aeruginosa (10.1%), and 18 other Gram-negative isolates (8.7%). Staphylococcus aureus represented 12.4% (n = 25). Among the isolates, resistance to at least one antibiotic was identified in 63% of them. Genes coding for extended-spectrum beta-lactamases and carbapenemases, blaCTX-M and blaKPC, respectively, were commonly found. Mortality rate was 25.6% and it was lower in those with adequate empirical antibiotic treatment (22.0% vs. 45.2%, OR: 0.26, 95% CI: 0.1-0.63, in the multivariate model). In Colombia, in patients with cancer and bacteremia, bacteria have a high resistance profile to beta-lactams, with a high incidence of extended-spectrum beta-lactamases and carbapenemases. Adequate empirical treatment diminishes mortality, and empirical selection of treatment in this environment of high resistance is of key importance.

Keywords: adults; bacteremia; beta-lactamases; drug resistance; infection; microbial; neoplasm.

PubMed Disclaimer

Conflict of interest statement

J.A.C. and C.A.Á.-M. have a research grant sponsored by Pfizer and the International Society of Infectious Diseases. C.H.S.-T. has research grants sponsored by Merck and Pfizer. A.L.L. has research grants sponsored by Merck Sharp and Dohme and Pfizer. The other authors have no conflicts of interest to declare.

References

    1. Freifeld A.G., Bow E.J., Sepkowitz K.A., Boeckh M.J., Ito J.I., Mullen C.A., Raad I.I., Rolston K.V., Young J.A., Wingard J.R., et al. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 Update by the Infectious Diseases Society of America. Clin. Infect. Dis. 2011;52:427–431. doi: 10.1093/cid/ciq147. - DOI - PubMed
    1. Cortes J.A., Cuervo S., Gomez C.A., Bermudez D., Martinez T., Arroyo P. Febrile neutropenia in the tropics: A description of clinical and microbiological findings and their impact on inappropriate therapy currently used at an oncological reference center in Colombia. Biomedica. 2013;33:70–77. doi: 10.1590/S0120-41572013000100009. - DOI - PubMed
    1. Viscoli C., Castagnola E. Factors predisposing cancer patients to infection. Cancer Treat Res. 1995;79:1–30. doi: 10.1007/978-1-4613-1239-0_1. - DOI - PubMed
    1. Gonzalez-Barca E., Fernandez-Sevilla A., Carratala J., Salar A., Peris J., Granena A., Gudiol F. Prognostic factors influencing mortality in cancer patients with neutropenia and bacteremia. Eur. J. Clin. Microbiol. Infect. Dis. 1999;18:539–544. doi: 10.1007/s100960050345. - DOI - PubMed
    1. World Health Organization . Global Action Plan on Antimicrobial Resistance. WHO; Geneva, Switzerland: 2015. pp. 1–28.

LinkOut - more resources