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Multi-drug resistant (MDR) and extensively drug-resistant (XDR) bacteraemia rates among cancer patients in an oncology hospital in eastern India: an 11-year retrospective observational study

BACKGROUND: Trend analysis of bacteraemias caused by multi-drug resistant (MDR) and extensively drug resistant (XDR) bacteria helps to assess efficacy of infection prevention and control (IPC) practices. Data on the trends of MDR and XDR bacteraemias are lacking from cancer patients in India. AIMS:...

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Autores principales: Mukherjee, Satyam, De, Maitrayee Sarkar, Goel, Gaurav, Bhattacharyya, Arpita, Mallick, Indranil, Dabkara, Deepak, Bhaumik, Jaydip, Roy, Manas Kumar, Majumdar, Piyali Bose, Chatterji, Soumyadip, Mukherjee, Sudipta, Bhattacharya, Sanjay, Chandy, Mammen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10006829/
https://www.ncbi.nlm.nih.gov/pubmed/36915471
http://dx.doi.org/10.1016/j.infpip.2023.100275
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author Mukherjee, Satyam
De, Maitrayee Sarkar
Goel, Gaurav
Bhattacharyya, Arpita
Mallick, Indranil
Dabkara, Deepak
Bhaumik, Jaydip
Roy, Manas Kumar
Majumdar, Piyali Bose
Chatterji, Soumyadip
Mukherjee, Sudipta
Bhattacharya, Sanjay
Chandy, Mammen
author_facet Mukherjee, Satyam
De, Maitrayee Sarkar
Goel, Gaurav
Bhattacharyya, Arpita
Mallick, Indranil
Dabkara, Deepak
Bhaumik, Jaydip
Roy, Manas Kumar
Majumdar, Piyali Bose
Chatterji, Soumyadip
Mukherjee, Sudipta
Bhattacharya, Sanjay
Chandy, Mammen
author_sort Mukherjee, Satyam
collection PubMed
description BACKGROUND: Trend analysis of bacteraemias caused by multi-drug resistant (MDR) and extensively drug resistant (XDR) bacteria helps to assess efficacy of infection prevention and control (IPC) practices. Data on the trends of MDR and XDR bacteraemias are lacking from cancer patients in India. AIMS: To report antibiotic resistance rates over time in bacteraemias and to assess the effect of IPC practices where patient isolation facilities were limited on the rates and trends of MDR and XDR bacteraemias from a cancer centre in eastern India. METHODS: A retrospective observational study was conducted in a specialist cancer hospital in India from 2011 to 2021. The study included both patients with haematological and solid organ malignancy. Data on blood cultures and surveillance culture samples were analysed. Blood cultures were processed using BACT/ALERT® (bioMérieux, Marcy-l'Étoile, France) and the identification and antibiotic susceptibilities of bacteria were performed using VITEK® 2 (bioMérieux, Marcy-l'Étoile, France). Surveillance cultures for MDR/XDR bacteria were performed on a subset of patients and processed based on a modified method described previously. FINDINGS: 3rd-generation cephalosporin-resistant Gram negative bacilli were the commonest cause of MDR bacteraemia (57.6%) followed by carbapenem resistant organisms (CRO) (35.7%). Bacteraemias caused by vancomycin-resistant enterococci (VRE), meticillin-resistant Staphylococcus aureus (MRSA) and colistin-resistant Gram negative bacilli were responsible for 1.3%, 2.3% and 3.0% of laboratory confirmed bloodstream infections (BSI) respectively. The ranges of the rates of MDR/XDR BSI per 1000 in-patients during the study period were: MRSA (1–1.18), VRE (0–0.88), 3(rd) generation cephalosporin-resistant Gram negative bacilli (10.10–20.32), CRO (5.05–13.07) and colistin-resistant Gram negative bacilli (E. coli, Klebsiella, Pseudomonas aeruginosa, Acinetobacter spp (0–1.3). Surveillance cultures collected from a subset of patients showed ranges of MRSA detection in 0–2.11%, VRE in 1.67%–7.49%, 3(rd) generation cephalosporin-resistant Gram negative bacilli in 55%–89.91% and carbapenem resistant Gram negative bacilli in 18.33%–31.11% of patients. CONCLUSION: This is one of few studies providing trend data for MDR/XDR bacteraemia rates among cancer patients in India over a decade. In a high prevalence setting it was possible to keep the rates of MDR/XDR bacteraemia controlled with IPC strategies and without adequate isolation facilities. The results are of potential interest to policy makers, IPC specialists and clinicians.
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spelling pubmed-100068292023-03-12 Multi-drug resistant (MDR) and extensively drug-resistant (XDR) bacteraemia rates among cancer patients in an oncology hospital in eastern India: an 11-year retrospective observational study Mukherjee, Satyam De, Maitrayee Sarkar Goel, Gaurav Bhattacharyya, Arpita Mallick, Indranil Dabkara, Deepak Bhaumik, Jaydip Roy, Manas Kumar Majumdar, Piyali Bose Chatterji, Soumyadip Mukherjee, Sudipta Bhattacharya, Sanjay Chandy, Mammen Infect Prev Pract Original Research Article BACKGROUND: Trend analysis of bacteraemias caused by multi-drug resistant (MDR) and extensively drug resistant (XDR) bacteria helps to assess efficacy of infection prevention and control (IPC) practices. Data on the trends of MDR and XDR bacteraemias are lacking from cancer patients in India. AIMS: To report antibiotic resistance rates over time in bacteraemias and to assess the effect of IPC practices where patient isolation facilities were limited on the rates and trends of MDR and XDR bacteraemias from a cancer centre in eastern India. METHODS: A retrospective observational study was conducted in a specialist cancer hospital in India from 2011 to 2021. The study included both patients with haematological and solid organ malignancy. Data on blood cultures and surveillance culture samples were analysed. Blood cultures were processed using BACT/ALERT® (bioMérieux, Marcy-l'Étoile, France) and the identification and antibiotic susceptibilities of bacteria were performed using VITEK® 2 (bioMérieux, Marcy-l'Étoile, France). Surveillance cultures for MDR/XDR bacteria were performed on a subset of patients and processed based on a modified method described previously. FINDINGS: 3rd-generation cephalosporin-resistant Gram negative bacilli were the commonest cause of MDR bacteraemia (57.6%) followed by carbapenem resistant organisms (CRO) (35.7%). Bacteraemias caused by vancomycin-resistant enterococci (VRE), meticillin-resistant Staphylococcus aureus (MRSA) and colistin-resistant Gram negative bacilli were responsible for 1.3%, 2.3% and 3.0% of laboratory confirmed bloodstream infections (BSI) respectively. The ranges of the rates of MDR/XDR BSI per 1000 in-patients during the study period were: MRSA (1–1.18), VRE (0–0.88), 3(rd) generation cephalosporin-resistant Gram negative bacilli (10.10–20.32), CRO (5.05–13.07) and colistin-resistant Gram negative bacilli (E. coli, Klebsiella, Pseudomonas aeruginosa, Acinetobacter spp (0–1.3). Surveillance cultures collected from a subset of patients showed ranges of MRSA detection in 0–2.11%, VRE in 1.67%–7.49%, 3(rd) generation cephalosporin-resistant Gram negative bacilli in 55%–89.91% and carbapenem resistant Gram negative bacilli in 18.33%–31.11% of patients. CONCLUSION: This is one of few studies providing trend data for MDR/XDR bacteraemia rates among cancer patients in India over a decade. In a high prevalence setting it was possible to keep the rates of MDR/XDR bacteraemia controlled with IPC strategies and without adequate isolation facilities. The results are of potential interest to policy makers, IPC specialists and clinicians. Elsevier 2023-02-18 /pmc/articles/PMC10006829/ /pubmed/36915471 http://dx.doi.org/10.1016/j.infpip.2023.100275 Text en © 2023 Published by Elsevier Ltd on behalf of The Healthcare Infection Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research Article
Mukherjee, Satyam
De, Maitrayee Sarkar
Goel, Gaurav
Bhattacharyya, Arpita
Mallick, Indranil
Dabkara, Deepak
Bhaumik, Jaydip
Roy, Manas Kumar
Majumdar, Piyali Bose
Chatterji, Soumyadip
Mukherjee, Sudipta
Bhattacharya, Sanjay
Chandy, Mammen
Multi-drug resistant (MDR) and extensively drug-resistant (XDR) bacteraemia rates among cancer patients in an oncology hospital in eastern India: an 11-year retrospective observational study
title Multi-drug resistant (MDR) and extensively drug-resistant (XDR) bacteraemia rates among cancer patients in an oncology hospital in eastern India: an 11-year retrospective observational study
title_full Multi-drug resistant (MDR) and extensively drug-resistant (XDR) bacteraemia rates among cancer patients in an oncology hospital in eastern India: an 11-year retrospective observational study
title_fullStr Multi-drug resistant (MDR) and extensively drug-resistant (XDR) bacteraemia rates among cancer patients in an oncology hospital in eastern India: an 11-year retrospective observational study
title_full_unstemmed Multi-drug resistant (MDR) and extensively drug-resistant (XDR) bacteraemia rates among cancer patients in an oncology hospital in eastern India: an 11-year retrospective observational study
title_short Multi-drug resistant (MDR) and extensively drug-resistant (XDR) bacteraemia rates among cancer patients in an oncology hospital in eastern India: an 11-year retrospective observational study
title_sort multi-drug resistant (mdr) and extensively drug-resistant (xdr) bacteraemia rates among cancer patients in an oncology hospital in eastern india: an 11-year retrospective observational study
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10006829/
https://www.ncbi.nlm.nih.gov/pubmed/36915471
http://dx.doi.org/10.1016/j.infpip.2023.100275
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