TY  - JOUR
A1  - Stratmann, Jan Alexander
A1  - Lacko, Raphael
A1  - Ballo, Olivier
A1  - Shaid, Shabnam
A1  - Gleiber, Wolfgang
A1  - Vehreschild, Maria J. G. T.
A1  - Wichelhaus, Thomas Alexander
A1  - Reinheimer, Claudia
A1  - Göttig, Stephan
A1  - Kempf, Volkhard A. J.
A1  - Kleine, Peter
A1  - Stera, Susanne
A1  - Brandts, Christian Hubertus
A1  - Sebastian, Martin
A1  - Koschade, Sebastian E.
T1  - Colonization with multi-drug-resistant organisms negatively impacts survival in patients with non-small cell lung cancer
T2  - PLOS ONE
N2  - Objectives: Multidrug-resistant organisms (MDRO) are considered an emerging threat worldwide. Data covering the clinical impact of MDRO colonization in patients with solid malignancies, however, is widely missing. We sought to determine the impact of MDRO colonization in patients who have been diagnosed with Non-small cell lung cancer (NSCLC) who are at known high-risk for invasive infections.
Materials and methods: Patients who were screened for MDRO colonization within a 90-day period after NSCLC diagnosis of all stages were included in this single-center retrospective study.
Results: Two hundred and ninety-five patients were included of whom 24 patients (8.1%) were screened positive for MDRO colonization (MDROpos) at first diagnosis. Enterobacterales were by far the most frequent MDRO detected with a proportion of 79.2% (19/24). MDRO colonization was present across all disease stages and more present in patients with concomitant diabetes mellitus. Median overall survival was significantly inferior in the MDROpos study group with a median OS of 7.8 months (95% CI, 0.0–19.9 months) compared to a median OS of 23.9 months (95% CI, 17.6–30.1 months) in the MDROneg group in univariate (p = 0.036) and multivariate analysis (P = 0.02). Exploratory analyses suggest a higher rate of non-cancer-related-mortality in MDROpos patients compared to MDROneg patients (p = 0.002) with an increased rate of fatal infections in MDROpos patients (p = 0.0002).
Conclusions: MDRO colonization is an independent risk factor for inferior OS in patients diagnosed with NSCLC due to a higher rate of fatal infections. Empirical antibiotic treatment approaches should cover formerly detected MDR commensals in cases of (suspected) invasive infections.
Y1  - 2020
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/61112
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-611121
SN  - 1932-6203
VL  - 15
IS  - (11) e0242544
SP  - 1
EP  - 16
PB  - Public Library of Science
CY  - San Francisco
ER  -