TY  - JOUR
A1  - Himmelsbach, Vera
A1  - Knabe, Mate
A1  - Ferstl, Philip
A1  - Peiffer, Kai-Henrik
A1  - Stratmann, Jan Alexander
A1  - Wichelhaus, Thomas Alexander
A1  - Hogardt, Michael
A1  - Kempf, Volkhard A. J.
A1  - Zeuzem, Stefan
A1  - Waidmann, Oliver
A1  - Finkelmeier, Fabian
A1  - Ballo, Olivier Karl Friedrich
T1  - Colonization with multidrug-resistant organisms impairs survival in patients with hepatocellular carcinoma
T2  - Journal of cancer research and clinical oncology
N2  - Introduction: MDRO-colonization has been shown to impair survival in patients with hematological malignancies and solid tumors as well as in patients with liver disease. Despite the increasing spread of multidrug-resistant organisms (MDRO), its impact on patients with hepatocellular carcinoma (HCC) has not been studied. We conducted this retrospective study to analyze the impact of MDRO-colonization on overall prognosis in HCC patients.
Materials and methods: All patients with confirmed HCC diagnosed between January 2008 and December 2017 at the University Hospital Frankfurt were included in this study. HCC patients with a positive MDRO screening before or within the first 90 days after diagnosis of HCC were defined as colonized HCC patients, HCC patients with a negative MDRO screening were defined as noncolonized HCC patients.
Results: 59 (6%) colonized and 895 (94%) noncolonized HCC patients were included. Enterobacterales with extended-spectrum β-lactamase-like phenotype with or without resistance to fluoroquinolones (ESBL/ ± FQ) were the most frequently found MDRO with 59%, followed by vancomycin-resistant Enterococcus faecium with 37%. Colonized HCC patients had more severe cirrhosis and more advanced HCC stage compared to noncolonized HCC patients. Colonized HCC patients showed an impaired survival with a median OS of 189 days (6.3 months) compared to a median OS of 1001 days (33.4 months) in noncolonized HCC patients. MDRO-colonization was identified as an independent risk factor associated with survival in multivariate analysis.
Conclusion: MDRO-colonization is an independent risk factor for survival in patients with HCC highlighting the importance of regular MDRO screening, isolation measures as well as interdisciplinary antibiotic steward-ship programs to guide responsible use of antibiotic agents.
KW  - Hepatocellular carcinoma
KW  - Multidrug-resistant organisms
KW  - Infection
KW  - Antibiotic steward-ship
KW  - Antibiotics
KW  - ESBL
KW  - VRE
KW  - Survival
KW  - Liver cancer
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/69759
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-697591
SN  - 1432-1335
N1  - Open Access funding enabled and organized by Projekt DEAL.
VL  - 148
IS  - 6
SP  - 1465
EP  - 1472
PB  - Springer
CY  - Berlin ; Heidelberg
ER  -