Multidrug-resistant Escherichia coli bacteremia in cancer patients

Karen J. Vigil; Javier A. Adachi; Halim Aboufaycal; Ray Y. Hachem; Ruth A. Reitzel; Ying Jiang; Jeffrey J. Tarrand; Roy F. Chemaly; Gerald P. Bodey; Kenneth V. Rolston; Isaam Raad

doi:10.1016/j.ajic.2009.02.002

Multidrug-resistant Escherichia coli bacteremia in cancer patients

Karen J. Vigil, Javier A. Adachi, Halim Aboufaycal, Ray Y. Hachem, Ruth A. Reitzel, Ying Jiang, Jeffrey J. Tarrand, Roy F. Chemaly, Gerald P. Bodey, Kenneth V. Rolston, Isaam Raad

Research output: Contribution to journal › Article › peer-review

19 Scopus citations

Abstract

Background: Multidrug-resistant (MDR) Escherichia coli is a serious threat to cancer patients. We aimed to determine the risk factors associated with the development of MDR E coli bacteremia in cancer patients and the possibility of horizontal transmission. Methods: We conducted a 1:2 case-control study of 58 patients with MDR E coli bacteremia. The patient's demographics, clinical characteristics, and antibiotic use were obtained. MDR E coli was defined as resistant strains to quinolones plus 1 of the following: piperacillin, ceftazidime, or cefepime. Repetitive sequence-based polymerase chain reaction (Rep-PCR) was used to identify DNA interstrain similarities. Results: Conditional multiple logistic analysis showed that admission to the hospital within the 30 days prior to infection and chemotherapy use were risk factors for infection with MDR E coli. Rep-PCR showed that, among the MDR E coli strains recovered, 48.6% showed >95% similarity, representing a possible clonal outbreak. Infection control measures were implemented and controlled this horizontal transmission. Conclusion: Prior admission to the hospital and previous chemotherapy were independent risk factors of acquiring MDR E coli. Molecular fingerprinting techniques detected a possible nosocomial clonal outbreak of MDR E coli, which was aborted through infection control measures.

Original language	English (US)
Pages (from-to)	741-745
Number of pages	5
Journal	American Journal of Infection Control
Volume	37
Issue number	9
DOIs	https://doi.org/10.1016/j.ajic.2009.02.002
State	Published - Nov 2009

ASJC Scopus subject areas

Epidemiology
Health Policy
Public Health, Environmental and Occupational Health
Infectious Diseases

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10.1016/j.ajic.2009.02.002

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@article{455c814dbc814bd3a51a03bd03e21de0,

title = "Multidrug-resistant Escherichia coli bacteremia in cancer patients",

abstract = "Background: Multidrug-resistant (MDR) Escherichia coli is a serious threat to cancer patients. We aimed to determine the risk factors associated with the development of MDR E coli bacteremia in cancer patients and the possibility of horizontal transmission. Methods: We conducted a 1:2 case-control study of 58 patients with MDR E coli bacteremia. The patient's demographics, clinical characteristics, and antibiotic use were obtained. MDR E coli was defined as resistant strains to quinolones plus 1 of the following: piperacillin, ceftazidime, or cefepime. Repetitive sequence-based polymerase chain reaction (Rep-PCR) was used to identify DNA interstrain similarities. Results: Conditional multiple logistic analysis showed that admission to the hospital within the 30 days prior to infection and chemotherapy use were risk factors for infection with MDR E coli. Rep-PCR showed that, among the MDR E coli strains recovered, 48.6% showed >95% similarity, representing a possible clonal outbreak. Infection control measures were implemented and controlled this horizontal transmission. Conclusion: Prior admission to the hospital and previous chemotherapy were independent risk factors of acquiring MDR E coli. Molecular fingerprinting techniques detected a possible nosocomial clonal outbreak of MDR E coli, which was aborted through infection control measures.",

author = "Vigil, {Karen J.} and Adachi, {Javier A.} and Halim Aboufaycal and Hachem, {Ray Y.} and Reitzel, {Ruth A.} and Ying Jiang and Tarrand, {Jeffrey J.} and Chemaly, {Roy F.} and Bodey, {Gerald P.} and Rolston, {Kenneth V.} and Isaam Raad",

year = "2009",

month = nov,

doi = "10.1016/j.ajic.2009.02.002",

language = "English (US)",

volume = "37",

pages = "741--745",

journal = "American Journal of Infection Control",

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T1 - Multidrug-resistant Escherichia coli bacteremia in cancer patients

AU - Vigil, Karen J.

AU - Adachi, Javier A.

AU - Aboufaycal, Halim

AU - Hachem, Ray Y.

AU - Reitzel, Ruth A.

AU - Jiang, Ying

AU - Tarrand, Jeffrey J.

AU - Chemaly, Roy F.

AU - Bodey, Gerald P.

AU - Rolston, Kenneth V.

AU - Raad, Isaam

PY - 2009/11

Y1 - 2009/11

N2 - Background: Multidrug-resistant (MDR) Escherichia coli is a serious threat to cancer patients. We aimed to determine the risk factors associated with the development of MDR E coli bacteremia in cancer patients and the possibility of horizontal transmission. Methods: We conducted a 1:2 case-control study of 58 patients with MDR E coli bacteremia. The patient's demographics, clinical characteristics, and antibiotic use were obtained. MDR E coli was defined as resistant strains to quinolones plus 1 of the following: piperacillin, ceftazidime, or cefepime. Repetitive sequence-based polymerase chain reaction (Rep-PCR) was used to identify DNA interstrain similarities. Results: Conditional multiple logistic analysis showed that admission to the hospital within the 30 days prior to infection and chemotherapy use were risk factors for infection with MDR E coli. Rep-PCR showed that, among the MDR E coli strains recovered, 48.6% showed >95% similarity, representing a possible clonal outbreak. Infection control measures were implemented and controlled this horizontal transmission. Conclusion: Prior admission to the hospital and previous chemotherapy were independent risk factors of acquiring MDR E coli. Molecular fingerprinting techniques detected a possible nosocomial clonal outbreak of MDR E coli, which was aborted through infection control measures.

AB - Background: Multidrug-resistant (MDR) Escherichia coli is a serious threat to cancer patients. We aimed to determine the risk factors associated with the development of MDR E coli bacteremia in cancer patients and the possibility of horizontal transmission. Methods: We conducted a 1:2 case-control study of 58 patients with MDR E coli bacteremia. The patient's demographics, clinical characteristics, and antibiotic use were obtained. MDR E coli was defined as resistant strains to quinolones plus 1 of the following: piperacillin, ceftazidime, or cefepime. Repetitive sequence-based polymerase chain reaction (Rep-PCR) was used to identify DNA interstrain similarities. Results: Conditional multiple logistic analysis showed that admission to the hospital within the 30 days prior to infection and chemotherapy use were risk factors for infection with MDR E coli. Rep-PCR showed that, among the MDR E coli strains recovered, 48.6% showed >95% similarity, representing a possible clonal outbreak. Infection control measures were implemented and controlled this horizontal transmission. Conclusion: Prior admission to the hospital and previous chemotherapy were independent risk factors of acquiring MDR E coli. Molecular fingerprinting techniques detected a possible nosocomial clonal outbreak of MDR E coli, which was aborted through infection control measures.

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Multidrug-resistant Escherichia coli bacteremia in cancer patients

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