Ibis de la Cruz-Hernández1, Patricia Cornejo-Juárez1, Odilia Tellez-Miranda2, Laura Barrera-Pérez2, Silvia Sandoval-Hernández3, Diana Vilar-Compte1, Consuelo Velázquez-Acosta4, Patricia Volkow5. 1. Infectious Diseases Department, Instituto Nacional de Cancerología, Mexico City, Mexico. 2. Intravenous Therapy Team, Instituto Nacional de Cancerología, Mexico City, Mexico. 3. Nosocomial Infectious Control Committee, Instituto Nacional de Cancerología, Mexico City, Mexico. 4. Microbiology Laboratory, Instituto Nacional de Cancerología, Mexico City, Mexico. 5. Infectious Diseases Department, Instituto Nacional de Cancerología, Mexico City, Mexico. Electronic address: pvolkowf@gmail.com.
Abstract
INTRODUCTION: Central venous catheters (CVCs) are essential for treating cancer patients, but infection is a risk associated with their use, particularly by multidrug-resistant (MDR) bacteria. The aim of this study was to describe the microbiology of catheter-related bloodstream infections (CRBSIs) in cancer patients and to compare the prevalence of MDR ESKAPE microorganisms (Enterococcus faecium, Staphylococcus spp, Klebsiella spp, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp) plus Escherichia coli (E2SKAPE). METHODS: Based on data from 2013 to 2015 from a prospective survey of CRBSIs by the intravenous therapy team, we describe the microbiology and compare the prevalence of MDR E2SKAPE strains between hospitalized patients and outpatients. RESULTS: A total of 469 episodes of CRBSI were diagnosed: 261 (62%) were in women; 87 (18.6%) occurred in hospitalized patients, and 382 (81.4%) in ambulatory patients; 27.5% of patients had a hematologic malignancy and 72.5% a solid tumor. The median time between CVC insertion and CRBSI was 116 days (interquartile range [IQR], 48-207). The most common bacteria isolated were Staphylococcus epidermidis (18.1%), S aureus (10.9%), E coli (7.7%), and Klebsiella spp (8.6%). E2SKAPE accounted for 35.6%. Methicillin-resistant Staphylococcus aureus (MRSA) (odds ratio [OR], 16.4; 95% confidence interval [CI], 1.6-114; P = .01), extended-spectrum beta-lactamase (ESBL) Klebsiella spp (OR, 26; 95% CI, 2-286; P = .007), and ESBL E coli (OR, 26; 95% CI, 2-286; P = .007) were significantly more frequently isolated from hospitalized vs ambulatory patients. CONCLUSIONS: MRSA, ESBL E. coli and ESBL Klebsiella spp were significantly more frequently isolated from hospitalized patients with CRBSI.
INTRODUCTION: Central venous catheters (CVCs) are essential for treating cancerpatients, but infection is a risk associated with their use, particularly by multidrug-resistant (MDR) bacteria. The aim of this study was to describe the microbiology of catheter-related bloodstream infections (CRBSIs) in cancerpatients and to compare the prevalence of MDR ESKAPE microorganisms (Enterococcus faecium, Staphylococcus spp, Klebsiella spp, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp) plus Escherichia coli (E2SKAPE). METHODS: Based on data from 2013 to 2015 from a prospective survey of CRBSIs by the intravenous therapy team, we describe the microbiology and compare the prevalence of MDR E2SKAPE strains between hospitalized patients and outpatients. RESULTS: A total of 469 episodes of CRBSI were diagnosed: 261 (62%) were in women; 87 (18.6%) occurred in hospitalized patients, and 382 (81.4%) in ambulatory patients; 27.5% of patients had a hematologic malignancy and 72.5% a solid tumor. The median time between CVC insertion and CRBSI was 116 days (interquartile range [IQR], 48-207). The most common bacteria isolated were Staphylococcus epidermidis (18.1%), S aureus (10.9%), E coli (7.7%), and Klebsiella spp (8.6%). E2SKAPE accounted for 35.6%. Methicillin-resistant Staphylococcus aureus (MRSA) (odds ratio [OR], 16.4; 95% confidence interval [CI], 1.6-114; P = .01), extended-spectrum beta-lactamase (ESBL) Klebsiella spp (OR, 26; 95% CI, 2-286; P = .007), and ESBL E coli (OR, 26; 95% CI, 2-286; P = .007) were significantly more frequently isolated from hospitalized vs ambulatory patients. CONCLUSIONS: MRSA, ESBL E. coli and ESBL Klebsiella spp were significantly more frequently isolated from hospitalized patients with CRBSI.