dc.creator | Castagnola, Elio | |
dc.creator | Bagnasco, Francesca | |
dc.creator | Mesini, Alessio | |
dc.creator | Agyeman, Philipp K. A. | |
dc.creator | Ammann, Roland A. | |
dc.creator | Carlesse, Fabianne | |
dc.creator | Santolaya de Pablo, Maria Elena | |
dc.creator | Groll, Andreas H. | |
dc.creator | Haeusler, Gabrielle M. | |
dc.creator | Lehrnbecher, Thomas | |
dc.creator | Simon, Arne | |
dc.creator | D’Amico, María Rosaría | |
dc.creator | Duong, Austin | |
dc.creator | Idelevich, Evgeny A. | |
dc.creator | Luckowitsch, Marie | |
dc.creator | Meli, Mariaclaudia | |
dc.creator | Menna, Giuseppe | |
dc.creator | Palmert, Sasha | |
dc.creator | Russo, Giovanna | |
dc.creator | Sarno, Marco | |
dc.creator | Solopova, Galina | |
dc.creator | Tondo, Annalisa | |
dc.creator | Traubici, Yona | |
dc.creator | Sung, Lillian | |
dc.date.accessioned | 2022-03-15T21:16:43Z | |
dc.date.accessioned | 2022-10-17T14:20:38Z | |
dc.date.available | 2022-03-15T21:16:43Z | |
dc.date.available | 2022-10-17T14:20:38Z | |
dc.date.created | 2022-03-15T21:16:43Z | |
dc.date.issued | 2021 | |
dc.identifier | Antibiotics 2021, 10, 266 | |
dc.identifier | 10.3390/antibiotics10030266 | |
dc.identifier | https://repositorio.uchile.cl/handle/2250/184210 | |
dc.identifier.uri | https://repositorioslatinoamericanos.uchile.cl/handle/2250/4419029 | |
dc.description.abstract | Bloodstream infections (BSI) are a severe complication of antineoplastic chemotherapy or
hematopoietic stem cell transplantation (HSCT), especially in the presence of antibiotic resistance
(AR). A multinational, multicenter retrospective study in patients aged 18 years, treated with
chemotherapy or HSCT from 2015 to 2017 was implemented to analyze AR among non-common skin commensals BSI. Risk factors associated with AR, intensive care unit (ICU) admission and mortality
were analyzed by multilevel mixed effects or standard logistic regressions. A total of 1291 BSIs
with 1379 strains were reported in 1031 patients. Among Gram-negatives more than 20% were
resistant to ceftazidime, cefepime, piperacillin-tazobactam and ciprofloxacin while 9% was resistant
to meropenem. Methicillin-resistance was observed in 17% of S. aureus and vancomycin resistance
in 40% of E. faecium. Previous exposure to antibiotics, especially to carbapenems, was significantly
associated with resistant Gram-negative BSI while previous colonization with methicillin-resistant
S. aureus was associated with BSI due to this pathogen. Hematological malignancies, neutropenia
and Gram-negatives resistant to >3 antibiotics were significantly associated with higher risk of ICU
admission. Underlying disease in relapse/progression, previous exposure to antibiotics, and need
of ICU admission were significantly associated with mortality. Center-level variation showed a
greater impact on AR, while patient-level variation had more effect on ICU admission and mortality.
Previous exposure to antibiotics or colonization by resistant pathogens can be the cause of AR BSI.
Resistant Gram-negatives are significantly associated with ICU admission and mortality, with a
significant role for the treating center too. The significant evidence of center-level variations on AR,
ICU admission and mortality, stress the need for careful local antibiotic stewardship and infection
control programs. | |
dc.language | en | |
dc.publisher | MDPI | |
dc.rights | http://creativecommons.org/licenses/by-nc-nd/3.0/us/ | |
dc.rights | Attribution-NonCommercial-NoDerivs 3.0 United States | |
dc.source | Antibiotics | |
dc.subject | Antibiotic resistance | |
dc.subject | Intensive care admission and mortality | |
dc.subject | Bloodstream infections | |
dc.subject | Pediatric patients | |
dc.subject | Chemotherapy | |
dc.subject | Allogeneic stem cell transplant | |
dc.title | Antibiotic resistant bloodstream infections in pediatric patients receiving chemotherapy or hematopoietic stem cell transplant: factors associated with development of resistance, intensive care admission and mortality | |
dc.type | Artículos de revistas | |