Fecal colonization by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli is associated with an increased risk of bacteremia by this strain, prolonged hospitalization, and higher related costs in patients with hematologic malignancies and severe neutropenia, a new study published in the journal Supportive Care in Cancer has shown.1
For this cohort study, researchers sought to assess the impact of fecal ESBL-producing E coli colonization on bloodstream infection, clinical outcome, and costs in this patient population. Researchers included 126 patients with a recent diagnosis of a hematologic malignancy. Of those, 63 had fecal colonized ESBL-producing E coli, while 63 were colonized by non-ESBL-producing E coli.
Results showed that 22.2% of patients with ESBL-producing E coli developed a bloodstream infection by this strain compared with 7.9% colonized with non-ESBL-producing E coli. Researchers found that 4.7% of patients colonized by ESBL-producing E coli developed a non-ESBL-producing E coli bloodstream infection, while 26.9% of those colonized by non-ESBL-producing E coli developed a non-ESBL-producing E coli bloodstream infection.
The study demonstrated the fecal colonization with ESBL-producing E coli increased the risk of bacteremia by the E coli strain (RR, 3.4; 95% CI: 1.5-7.8; P=.001). It was also associated with a shorter time to death (P<.001), longer hospital stay (P=.01), and higher infection-related costs (P=.01).
Researchers observed no difference in overall mortality between the 2 groups.
1. Cornejo-Juárez P, Suárez-Cuenca JA, Volkow-Fernández P, et al. Fecal ESBL Escherichia coli carriage as a risk factor for bacteremia in patients with hematological malignancies. Supp Care Cancer. 2016;24(1):253-259.