Vera Himmelsbach, Mate Knabe, Philip Ferstl, Kai-Henrik Peiffer, Jan Alexander Stratmann, Thomas Alexander Wichelhaus, Michael Hogardt, Volkhard A. J. Kempf, Stefan Zeuzem, Oliver Waidmann, Fabian Finkelmeier, Olivier Karl Friedrich Ballo
- 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.
MetadatenAuthor: | Vera HimmelsbachGND, Mate KnabeORCiD, Philip FerstlORCiDGND, Kai-Henrik PeifferORCiDGND, Jan Alexander StratmannORCiDGND, Thomas Alexander WichelhausORCiD, Michael HogardtORCiDGND, Volkhard A. J. KempfORCiDGND, Stefan ZeuzemORCiDGND, Oliver WaidmannORCiDGND, Fabian FinkelmeierORCiDGND, Olivier Karl Friedrich BalloORCiDGND |
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URN: | urn:nbn:de:hebis:30:3-697591 |
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DOI: | https://doi.org/10.1007/s00432-021-03741-0 |
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ISSN: | 1432-1335 |
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Parent Title (English): | Journal of cancer research and clinical oncology |
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Publisher: | Springer |
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Place of publication: | Berlin ; Heidelberg |
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Document Type: | Article |
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Language: | English |
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Date of Publication (online): | 2021/07/20 |
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Date of first Publication: | 2021/07/20 |
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Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
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Release Date: | 2023/03/03 |
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Tag: | Antibiotic steward-ship; Antibiotics; ESBL; Hepatocellular carcinoma; Infection; Liver cancer; Multidrug-resistant organisms; Survival; VRE |
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Volume: | 148 |
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Issue: | 6 |
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Page Number: | 8 |
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First Page: | 1465 |
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Last Page: | 1472 |
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Note: | Open Access funding enabled and organized by Projekt DEAL. |
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HeBIS-PPN: | 507154371 |
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Institutes: | Medizin |
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Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
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Sammlungen: | Universitätspublikationen |
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Licence (German): | Creative Commons - Namensnennung 4.0 |
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