Lazar Trajković, Mirjana Cvetković, Mirjana Mitrović, Zlatko Pravdić, Nikola Pantić, Nikica Sabljić, Ljubomir Jaković, Ana Vidović, Nada Suvajdžić-Vuković, Marijana Virijević
{"title":"Antibiotic resistance patterns of multidrug resistant bacteria in acute myeloid leukemia patients during induction treatment.","authors":"Lazar Trajković, Mirjana Cvetković, Mirjana Mitrović, Zlatko Pravdić, Nikola Pantić, Nikica Sabljić, Ljubomir Jaković, Ana Vidović, Nada Suvajdžić-Vuković, Marijana Virijević","doi":"10.3855/jidc.20760","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The treatment of acute myeloid leukemia (AML) is accompanied by infectious complications, particularly during induction. The surge of multi-drug resistant (MDR) bacteria represents an additional problem for the health care of patients with AML.</p><p><strong>Methodology: </strong>A retrospective analysis of infectious complications was performed in 84 patients with AML undergoing induction therapy hospitalized between October 2020 and April 2023 at the Clinic of Hematology, University Clinical Centre of Serbia.</p><p><strong>Results: </strong>From 84 patients and 95 bacterial isolates, Enterococcus spp. was the most frequent Gram-positive bacterium (26%), showing a 56% resistance rate to vancomycin, and a 77.3% resistance rate to carbapenems, with a 4.3% resistance rate to linezolid and no resistance to tigecycline detected. The most common Gram-negative bacterium, Klebsiella spp. (28%), was resistant to cephalosporins, carbapenems, fluoroquinolones (88%, 84.6%, and 88.5% respectively), with a sizeable resistance rate to ceftazidime/avibactam and colistin (20% and 36.4% respectively). XDR Klebsiella spp. dominated the isolated strains, being detected in 57.7% of cultures, whereas Enterococcus spp. was identified as MDR or XDR in 40% and 28% respectively. The factors associated with developing MDR infections were ECOG PS > 2 (p = 0.024), sepsis (p = 0.0016), and the presence of two or more infectious syndromes (p = 0.016). Patients with a confirmed MDR bacterial infection had a mortality rate of 36.7%.</p><p><strong>Conclusions: </strong>Our work demonstrates that the frequency of infections in this population is high, especially with MDR and XDR strains of Klebsiella spp. and Enterococcus spp., which are accompanied by high rates of early death.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"19 3","pages":"362-369"},"PeriodicalIF":1.4000,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Infection in Developing Countries","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3855/jidc.20760","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Antibiotic resistance patterns of multidrug resistant bacteria in acute myeloid leukemia patients during induction treatment.
Introduction: The treatment of acute myeloid leukemia (AML) is accompanied by infectious complications, particularly during induction. The surge of multi-drug resistant (MDR) bacteria represents an additional problem for the health care of patients with AML.
Methodology: A retrospective analysis of infectious complications was performed in 84 patients with AML undergoing induction therapy hospitalized between October 2020 and April 2023 at the Clinic of Hematology, University Clinical Centre of Serbia.
Results: From 84 patients and 95 bacterial isolates, Enterococcus spp. was the most frequent Gram-positive bacterium (26%), showing a 56% resistance rate to vancomycin, and a 77.3% resistance rate to carbapenems, with a 4.3% resistance rate to linezolid and no resistance to tigecycline detected. The most common Gram-negative bacterium, Klebsiella spp. (28%), was resistant to cephalosporins, carbapenems, fluoroquinolones (88%, 84.6%, and 88.5% respectively), with a sizeable resistance rate to ceftazidime/avibactam and colistin (20% and 36.4% respectively). XDR Klebsiella spp. dominated the isolated strains, being detected in 57.7% of cultures, whereas Enterococcus spp. was identified as MDR or XDR in 40% and 28% respectively. The factors associated with developing MDR infections were ECOG PS > 2 (p = 0.024), sepsis (p = 0.0016), and the presence of two or more infectious syndromes (p = 0.016). Patients with a confirmed MDR bacterial infection had a mortality rate of 36.7%.
Conclusions: Our work demonstrates that the frequency of infections in this population is high, especially with MDR and XDR strains of Klebsiella spp. and Enterococcus spp., which are accompanied by high rates of early death.
期刊介绍：
The Journal of Infection in Developing Countries (JIDC) is an international journal, intended for the publication of scientific articles from Developing Countries by scientists from Developing Countries.
JIDC is an independent, on-line publication with an international editorial board. JIDC is open access with no cost to view or download articles and reasonable cost for publication of research artcles, making JIDC easily availiable to scientists from resource restricted regions.
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