Colonization with multi-drug-resistant organisms negatively impacts survival in patients with non-small cell lung cancer

  • 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.
Author:Jan Alexander StratmannGND, Raphael Lacko, Olivier BalloORCiDGND, Shabnam Shaid, Wolfgang Gleiber, Maria J. G. T. VehreschildORCiDGND, Thomas Alexander Wichelhaus, Claudia Reinheimer, Stephan GöttigORCiDGND, Volkhard A. J. KempfORCiDGND, Peter Kleine, Susanne Stera, Christian Hubertus BrandtsORCiDGND, Martin Sebastian, Sebastian E. KoschadeORCiDGND
Parent Title (English):PLOS ONE
Publisher:Public Library of Science
Place of publication:San Francisco
Document Type:Article
Date of Publication (online):2020/11/25
Date of first Publication:2020/11/25
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2021/06/09
Issue:(11) e0242544
Page Number:16
First Page:1
Last Page:16
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0