Molecular analysis and risk factors for Escherichia coli producing extended-spectrum β-lactamase bloodstream infection in hematological malignancies.

<h4>Introduction</h4>Patients with hematologic malignancies have greater risk-factors for primary bloodstream infections (BSI).<h4>Methods</h4>From 2004-2009, we analyzed bacteremia caused by extended-spectrum beta-lactamase Escherichia coli (ESBL-EC) (n = 100) and we compare...

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Autores principales:	Patricia Cornejo-Juárez, Carolina Pérez-Jiménez, Jesús Silva-Sánchez, Consuelo Velázquez-Acosta, Fernanda González-Lara, Fernando Reyna-Flores, Alejandro Sánchez-Pérez, Patricia Volkow-Fernández
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/522b5ba9fb3342c2873ebc8466ad43b9
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spelling	oai:doaj.org-article:522b5ba9fb3342c2873ebc8466ad43b92021-11-18T07:21:13ZMolecular analysis and risk factors for Escherichia coli producing extended-spectrum β-lactamase bloodstream infection in hematological malignancies.1932-620310.1371/journal.pone.0035780https://doaj.org/article/522b5ba9fb3342c2873ebc8466ad43b92012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22540004/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Introduction</h4>Patients with hematologic malignancies have greater risk-factors for primary bloodstream infections (BSI).<h4>Methods</h4>From 2004-2009, we analyzed bacteremia caused by extended-spectrum beta-lactamase Escherichia coli (ESBL-EC) (n = 100) and we compared with bacteremia caused by cephalosporin-susceptible E. coli (n = 100) in patients with hematologic malignancies.<h4>Objective</h4>To assess the clinical features, risk factors, and outcome of ESBL-EC BSI in patients with hematologic malignancies, and to study the molecular epidemiology of ESBL-EC isolates.<h4>Results</h4>The main diagnosis was acute leukemia in 115 patients (57.5%). Death-related E. coli infection was significantly increased with ESBL-EC (34% vs. control group, 19%; p = 0.03). Treatment for BSI was considered appropriate in 64 patients with ESBL-EC (mean survival, 245 ± 345 days), and in 45 control patients this was 443 ± 613 (p = 0.03). In patients not receiving appropriate antimicrobial treatment, survival was significantly decreased in cases compared with controls (26 ± 122 vs. 276 ± 442; p = 0.001). Fifty six of the ESBL-EC isolates were characterized by molecular analysis: 47 (84%) expressed CTX-M-15, two (3.6%) SHV, and seven (12.5%) did not correspond to either of these two ESBL enzymes. No TLA-1 enzyme was detected.<h4>Conclusions</h4>Patients who had been previously hospitalized and who received cephalosporins during the previous month, have an increased risk of ESBL-EC bacteremia. Mortality was significantly increased in patients with ESBL-EC BSI. A polyclonal trend was detected, which reflects non-cross transmission of multiresistant E.coli isolates.Patricia Cornejo-JuárezCarolina Pérez-JiménezJesús Silva-SánchezConsuelo Velázquez-AcostaFernanda González-LaraFernando Reyna-FloresAlejandro Sánchez-PérezPatricia Volkow-FernándezPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 4, p e35780 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Patricia Cornejo-Juárez Carolina Pérez-Jiménez Jesús Silva-Sánchez Consuelo Velázquez-Acosta Fernanda González-Lara Fernando Reyna-Flores Alejandro Sánchez-Pérez Patricia Volkow-Fernández Molecular analysis and risk factors for Escherichia coli producing extended-spectrum β-lactamase bloodstream infection in hematological malignancies.
description	<h4>Introduction</h4>Patients with hematologic malignancies have greater risk-factors for primary bloodstream infections (BSI).<h4>Methods</h4>From 2004-2009, we analyzed bacteremia caused by extended-spectrum beta-lactamase Escherichia coli (ESBL-EC) (n = 100) and we compared with bacteremia caused by cephalosporin-susceptible E. coli (n = 100) in patients with hematologic malignancies.<h4>Objective</h4>To assess the clinical features, risk factors, and outcome of ESBL-EC BSI in patients with hematologic malignancies, and to study the molecular epidemiology of ESBL-EC isolates.<h4>Results</h4>The main diagnosis was acute leukemia in 115 patients (57.5%). Death-related E. coli infection was significantly increased with ESBL-EC (34% vs. control group, 19%; p = 0.03). Treatment for BSI was considered appropriate in 64 patients with ESBL-EC (mean survival, 245 ± 345 days), and in 45 control patients this was 443 ± 613 (p = 0.03). In patients not receiving appropriate antimicrobial treatment, survival was significantly decreased in cases compared with controls (26 ± 122 vs. 276 ± 442; p = 0.001). Fifty six of the ESBL-EC isolates were characterized by molecular analysis: 47 (84%) expressed CTX-M-15, two (3.6%) SHV, and seven (12.5%) did not correspond to either of these two ESBL enzymes. No TLA-1 enzyme was detected.<h4>Conclusions</h4>Patients who had been previously hospitalized and who received cephalosporins during the previous month, have an increased risk of ESBL-EC bacteremia. Mortality was significantly increased in patients with ESBL-EC BSI. A polyclonal trend was detected, which reflects non-cross transmission of multiresistant E.coli isolates.
format	article
author	Patricia Cornejo-Juárez Carolina Pérez-Jiménez Jesús Silva-Sánchez Consuelo Velázquez-Acosta Fernanda González-Lara Fernando Reyna-Flores Alejandro Sánchez-Pérez Patricia Volkow-Fernández
author_facet	Patricia Cornejo-Juárez Carolina Pérez-Jiménez Jesús Silva-Sánchez Consuelo Velázquez-Acosta Fernanda González-Lara Fernando Reyna-Flores Alejandro Sánchez-Pérez Patricia Volkow-Fernández
author_sort	Patricia Cornejo-Juárez
title	Molecular analysis and risk factors for Escherichia coli producing extended-spectrum β-lactamase bloodstream infection in hematological malignancies.
title_short	Molecular analysis and risk factors for Escherichia coli producing extended-spectrum β-lactamase bloodstream infection in hematological malignancies.
title_full	Molecular analysis and risk factors for Escherichia coli producing extended-spectrum β-lactamase bloodstream infection in hematological malignancies.
title_fullStr	Molecular analysis and risk factors for Escherichia coli producing extended-spectrum β-lactamase bloodstream infection in hematological malignancies.
title_full_unstemmed	Molecular analysis and risk factors for Escherichia coli producing extended-spectrum β-lactamase bloodstream infection in hematological malignancies.
title_sort	molecular analysis and risk factors for escherichia coli producing extended-spectrum β-lactamase bloodstream infection in hematological malignancies.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/522b5ba9fb3342c2873ebc8466ad43b9
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Molecular analysis and risk factors for Escherichia coli producing extended-spectrum β-lactamase bloodstream infection in hematological malignancies.

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