Bacterial infections in hospitalized cancer patients. The role of drug-resistant pathogens

Cover Page

Cite item

Full Text

Abstract

Aim. To present data on the structure of bacterial pathogens causing infectionsin cancer patients atthe N.N. Blokhin National Research Center of Oncology and analyze them in comparison with data of domestic and foreign literary sources.

Materials and methods. The data of 11,853 microorganisms isolated from patients hospitalized in the N.N. Blokhin National Research Center of Oncology in 2023 were analyzed.

Results. Bacteria accounted for 90.0 % of all isolated microorganisms and only 10.0 % were fungal pathogens. Despite the fact that gram-negative pathogens have given way to gram-positive pathogens in absolute numbers, gram-negative microorganisms (60.7 %) still prevail in “clinically significant” biomaterials (blood, spinal fluid, urine, wound discharge, BAL, etc.), primarily Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii and others. With the exception of Escherichia coli, a high percentage of carbapenem-resistant strains is noted for other pathogens: Klebsiella pneumoniae – 34 %, Pseudomonas aeruginosa – 50 %, Acinetobacter baumannii – 69 %. Real-time polymerase chain reaction revealed the leading carbapenemases: in Klebsiella pneumoniae strains – KPC or OXA-48 carbapenemases were detected in 55 % of cases, and NDM metallo-β-lactamasesin 45 %; in Pseudomonas aeruginosa strains – VIM metallo-β-lactamases were registered in 29 % of cases. Among gram-positive microorganisms, the most problematic is vancomycinresistant Enterococcus faecium. It accounts for 45 % of all E. faecium strains.

Conclusion. Along with modern diagnostics and infection control measures, knowledge of the leading microbiota in a particular clinic will prevent the spread of infection and provide timely medical care to patients.

About the authors

I. N. Petukhova

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Author for correspondence.
Email: irinapet@list.ru
ORCID iD: 0000-0003-3077-0447

24 Kashirskoye Shosse, Moscow 115522

Russian Federation

Z. V. Grigoryevskaya

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

ORCID iD: 0000-0003-4294-1995

24 Kashirskoye Shosse, Moscow 115522

Russian Federation

N. S. Bagirova

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

ORCID iD: 0000-0003-1405-3536

24 Kashirskoye Shosse, Moscow 115522

Russian Federation

V. V. Aginova

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

ORCID iD: 0000-0003-1787-2676

24 Kashirskoye Shosse, Moscow 115522

Russian Federation

References

  1. Delgado A., Guddati A.K. Infections in hospitalized cancer patients. World J Oncol 2021;12(6):195–205. doi: 10.14740/wjon1410
  2. Rolston K.V. Infections in cancer patients with solid tumors: a review. Infect Dis Ther 2017;6(1):69–83. doi: 10.1007/s40121-017-0146-1
  3. Petukhova I.N., Dmitriyeva N.V. Infections in oncology and dysbacteriosis treatment. In: Rational pharmacotherapy in oncology. Ed. by M.I. Davydov, V.A. Gorbunova. Moscow: Litterra, 2015. Pp. 686–691. (In Russ.).
  4. Freedberg D.E., Zhou M.J., Cohen M.E. et al. Pathogen colonization of the gastrointestinal microbiome at intensive care unit admission and risk for subsequent death or infection. Intensive Care Med 2018;44(8):1203–11. doi: 10.1007/s00134-018-5268-8
  5. Bagirova N.S., Petukhova I.N., Grigorievskaya Z.V., Aginova V.V. Nosocomial infections in cancer patients: pathogens profile and resistance. Klinicheskaya laboratornaya diagnostika = Russian Clinical Laboratory Diagnostics 2024;69(3):153–65. (In Russ.). doi: 10.51620/0869-2084-2024-69-3-153-165
  6. Kutsevalova O.Yu., Rozenko D.A., Kozel Yu.Yu. et al. Etiological characteristics in causative agents of infectious complications in cancer patients. Antibiotiki i Khimioterapiya = Antibiotics and Chemotherapy 2022;67(5–6):30–38. (In Russ.). doi: 10.37489/0235-2990-2022-67-5-6-30-38
  7. Bagirova N.S., Klyuchnikova I.A., Sytov A.V. et al. True and false bacteremia: ways of solving the problem. Klinicheskaya laboratornaya diagnostika = Russian Clinical Laboratory Diagnostics 2023;68(1):47–55. (In Russ.). doi: 10.51620/0869-2084-2023-68-1-47-55
  8. Bagirova N.S. The true or false bacteriemia: the significance of evaluation criteria of clinical significance of positive hemoculture. Klinicheskaya laboratornaya diagnostika = Russian Clinical Laboratory Diagnostics 2015;60(8):55–61. (In Russ.).
  9. Kang C.I, Song J.H., Ko K.S. et al. Clinical features and outcomes of Staphylococcus aureus infections in non-neutropenic cancer patients. Support Care Cancer 2012;20(3):483–8. doi: 10.1007/s00520-011-1100-5
  10. Kim S.H., Kim K.H., Kim H.B. et al. Outcome of vancomycin treatment in patients with methicillin-susceptible Staphylococcus aureus bacteremia. Antimicrob Agents Chemother 2008;52(1):192–7. doi: 10.1128/AAC.00700-07
  11. Shelburne S.A. 3rd, Tarrand J., Rolston K.V. Review of streptococcal bloodstream infections at a comprehensive cancer care center, 2000–2011. J Infect 2013;66(2):136–46. doi: 10.1016/j.jinf.2012.11.007
  12. Marron A., Carratalà J., Gonzalez-Barca E. et al. Serious complications of bacteremia caused by Viridans streptococci in neutropenic patients with cancer. Clin Infect Dis 2000;31(5):1126–30. doi: 10.1086/317460
  13. Ruhayel S., Foley D., Hamilton K. et al. Viridans group streptococci in leukemia and stem cell transplant: review of a risk-stratified guideline for empiric vancomycin in febrile neutropenia. Pediatr Infect Dis J 2021;40(9):832–4. doi: 10.1097/INF.0000000000003210
  14. Klyasova G.A., Fedorova A.V., Frolova I.N. et al. Antimicrobial resistance of nosocomial Enterococcus spp. isolated from blood culture in patients with hematological malignancies. Klinicheskaya mokrobiologiya i antimikrobnaya khimioterapiya = Clinical Microbiology and Antimicrobial Chemotherapy 2018;20(2):142–9. (In Russ.).
  15. Averyanova M.Yu., Vavilov V.N., Bondarenko S.N. et al. Bacterial infections in pediatric and adolescent in allogeneic hematopoietic stem cell transplantation recipients: etiology, structure, risk factors. Zhurnal infektologii = Journal Infectology 2013;5(1):35–43. (In Russ.). doi: 10.22625/2072-6732-2013-5-1-35-43
  16. Lee J.H., Kim S.-K., Kim S.K. et al. Increase in antibiotic-resistant gram-negative bacterial infections in febrile neutropenic children. Infect Chemother 2016;48(3):181–9. doi: 10.3947/ic.2016.48.3.181
  17. Trecarichi E.M., Tumbarello M. Antimicrobial-resistant Gram-negative bacteria in febrile neutropenic patients with cancer: current epidemiology and clinical impact. Curr Opin Infect Dis 2014;27(2):200–10. doi: 10.1097/QCO.0000000000000038
  18. Tandilova K.S., Klyasova G.A. Infectious complications caused by carbapenemase-producing Enterobacterales in patients with hematological disorders. Onkogematologiya = Oncohematology 2019;14(3):77–89. (In Russ.). doi: 10.17650/1818-8346-2019-14-3-77-89
  19. Petukhova I.N., Grigorievskaya Z.V., Sytov A.V. et al. Sepsis, septic shock. The causative agent of the infection: is there a difference in approaches? What about carbapenem-resistant pathogens? Zlokachestvenniye opukholy = Malignant tumors 2022;12(3s1):76–87. doi: 10.18027/2224-5057-2022-12-3s1-76-87
  20. Freire M.P., Pierrotti L.C., Filho H.H. et al. Infection with Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae in cancer patients. Eur J Clin Microbiol Infect Dis 2015;34(2):277–86. doi: 10.1007/s10096-014-2233-5
  21. Grigoryevskaya Z.V., Petukhova I.N., Dmitrieva N.V. Outbreak of hospital-aquired infection caused by multidrug resistant strains of K. pneumonie. Sibirskiy onkologicheskiy zhurnal = Siberian Journal of Oncology 2014;(2):5–8. (In Russ.).
  22. Petukhova I.N., Grigorievskaya Z.V., Bagirova N.S. et al. Bacterial pathogens of infections in cancer patients: where are we going? Zlokachestvenniye opukholy = Malignant tumors 2020;10(3s1):30–8. (In Russ.). doi: 10.18027/2224-5057-2020-10-3s1-30-38
  23. Dmitrieva N.V., Grigorievskaya Z.V., Petukhova I.N., Kulaga E.V. Nosocomial infections: the problem of increasing resistance of microorganisms. In: Sepsis. Selected issues of diagnosis and treatment. Ed. by N.V. Dmitrieva, I.N. Petukhova, E.G. Gromova. Moscow, 2018. Pp. 93–134.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2024 Petukhova I.N., Grigoryevskaya Z.V., Bagirova N.S., Aginova V.V.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77-86325 от  11.12.2023.