TY  - JOUR
A1  - Ballo, Olivier Karl Friedrich
A1  - Tarazzit, Ikram
A1  - Stratmann, Jan Alexander
A1  - Reinheimer, Claudia
A1  - Hogardt, Michael
A1  - Wichelhaus, Thomas Alexander
A1  - Kempf, Volkhard A. J.
A1  - Serve, Hubert
A1  - Finkelmeier, Fabian
A1  - Brandts, Christian Hubertus
T1  - Colonization with multidrug resistant organisms determines the clinical course of patients with acute myeloid leukemia undergoing intensive induction chemotherapy
T2  - PLoS one
N2  - Introduction: The global spread of multidrug-resistant organisms (MDRO) complicates treatment and isolation measures in hospitals and has shown to increase mortality. Patients with disease- or therapy-related immunodeficiency are especially at risk for fatal infections caused by MDRO. The impact of MDRO colonization on the clinical course of AML patients undergoing intensive induction chemotherapy—a potentially curative but highly toxic treatment option—has not been systematically studied.
Materials & methods: 312 AML patients undergoing intensive induction chemotherapy between 2007 and 2015 were examined for MDRO colonization. Patients with evidence for MDRO before or during the hospital stay of induction chemotherapy were defined as colonized, patients who never had a positive swab for MDRO were defined as noncolonized.
Results: Of 312 AML patients 90 were colonized and 130 were noncolonized. Colonized patients suffered from significantly more days with fever, spent more days on the intensive care unit and had a higher median C-reactive protein value during the hospital stay. These findings did not result in a prolonged length of hospital stay or an increased mortality rate for colonized patients. However, in a subgroup analysis, patients colonized with carbapenem-resistant enterobacteriaceae (CRE) had a significantly reduced 60- and 90-day, as well as 1- and 2-year survival rates when compared to noncolonized patients.
Conclusion: Our analysis highlights the importance of intensive MDRO screening especially in patients with febrile neutropenia since persisting fever can be a sign of MDRO-colonization. CRE-colonized patients require special surveillance, since they seem to be at risk for death.
KW  - Chemotherapy
KW  - Hospitals
KW  - Acute myeloid leukemia
KW  - Death rates
KW  - Fevers
KW  - Enterobacteriaceae
KW  - Methicillin-resistant Staphylococcus aureus
KW  - Neutropenia
Y1  - 2019
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/48840
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-488403
SN  - 1932-6203
N1  - Copyright: © 2019 Ballo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
VL  - 14
IS  - (1): e0210991
SP  - 1
EP  - 12
PB  - PLoS
CY  - Lawrence, Kan.
ER  -