Journal Mobile Options
Table of Contents
Vol. 57, No. 4, 2011
Issue release date: September 2011
Chemotherapy 2011;57:335–338
(DOI:10.1159/000329661)

Incidence of Fluoroquinolone-Resistant and Extended-Spectrum β-Lactamase-Producing Escherichia coli at a Comprehensive Cancer Center in the United States

Bhusal Y. · Mihu C.N. · Tarrand J.J. · Rolston K.V.
aBaylor College of Medicine and bUniversity of Texas MD Anderson Cancer Center, Houston, Tex., USA

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

Background: Quinolones are used extensively for prophylaxis in high-risk cancer patients; however, increasing quinolone resistance is being reported. Extended-spectrum β-lactamase (ESBL)-producing E. coli may be associated with increased morbidity and mortality particularly in neutropenic cancer patients. Methods: We conducted a retrospective study of consecutive E. coli isolates from January 2009 to August 2009 at our institution. Data on antimicrobial susceptibility of E. coli isolates to commonly used antimicrobial agents and the frequency of ESBL production and fluoroquinolone resistance were gathered based on CLSI guidelines. Results: There were 443 isolates of E. coli recovered. The majority were from urine cultures (308 isolates, 69.5%). Forty-one (9.2%) isolates were ESBL producing. Nine (18.3%) of the 49 isolates recovered from blood stream infections were ESBL producing. Quinolone resistance was present in 204 isolates (46%). Carbapenems and aminoglycosides retained excellent activity. E. coli resistance to quinolones increasedfrom 13 to 46% in a period of 13 years (p = 0.001). Conclusion: The incidence of resistance to quinolones at our center may be increasing as a consequence of widespread use of quinolones as prophylaxis for neutropenic patients. ESBL-producing E. coli are frequent at our center and are associated with blood stream infections.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Rolston KV, Tarrand JJ: Pseudomonas aeruginosa – still a frequent pathogen in patients with cancer: 11-year experience at a comprehensive cancer center. Clin Infect Dis 1999;29:463–464.
  2. Bucaneve G, Micozzi A, Menichetti F, Martino P, Dionisi MS, Martinelli G, Allione B, D’Antonio D, Buelli M, Nosari AM, Cilloni D, Zuffa E, Cantaffa R, Specchia G, Amadori S, Fabbiano F, Deliliers GL, Lauria F, Foà R, Del Favero A: Gruppo Italiano Malattie Ematologiche dell’Adulto (GIMEMA) Infection Program: Levofloxacin to prevent bacterial infection in patients with cancer and neutropenia. N Engl J Med 2005;353:977–987.
  3. Polk RE, Johnson CK, McClish D, Wenzel RP, Edmond MB: Predicting hospital rates of fluoroquinolone-resistant Pseudomonas aeruginosa from fluoroquinolone use in US hospitals and their surrounding communities. Clin Infect Dis 2004;39:497–503.
  4. Cattaneo C, Quaresmini G, Casari S, Capucci MA, Micheletti M, Borlenghi E, Signorini L, Re A,Carosi G, Rossi G: Recent changes in bacterial epidemiology and the emergence of fluoroquinolone-resistant Escherichia coli among patients with haematological malignancies: results of a prospective study on 823 patients at a single institution. J Antimicrob Chemother 2008;61:721–728.
  5. Kunz AN, Brook I: Emerging resistant Gram-negative aerobic bacilli in hospital-acquired infections. Chemotherapy 2010;56:492–500.
  6. Clinical and Laboratory Standards Institute: Performance Standards for Antimicrobial Susceptibility Testing: Nineteenth Informational Supplement, M100-S19, ed 19. Wayne, Clinical and Laboratory Standards Institute, 2009.
  7. Jacobson K, Rolston K, Elting L, LeBlanc B, Whimbey E, Ho DH: Susceptibility surveillance among Gram-negative bacilli at a cancer center. Chemotherapy 1999;45:325–334.
  8. Rangaraj G, Granwehr BP, Jiang Y, Hachem R, Raad I: Perils of quinolone exposure in cancer patients: breakthrough bacteremia with multidrug-resistant organisms. Cancer 2010;116:967–973.
  9. Mihu CN, Rhomberg PR, Jones RN, Coyle E, Prince R, Rolston KV: Escherichia coli resistance to quinolones at a comprehensive cancer center. Diagn Microbiol Infect Dis 2010;67:266–269.
  10. Koksal F, Ak K, Kucukbasmaci O, Samasti M: Prevalence and antimicrobial resistance patterns of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolated from blood cultures in an Istanbul university hospital. Chemotherapy 2009;55:293–297.
  11. Wisplinghoff H, Seifert H, Wenzel R, Edmond MB: Current trends in the epidemiology of nosocomial bloodstream infections in patients with hematological malignancies and solid neoplasms in hospitals in the United States. Clin Infect Dis 2003;36:1103–1110.


Pay-per-View Options
Direct payment This item at the regular price: USD 33.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 23.00