Risk of infection in cancer patients colonized by extended expectrum beta-lactamases and carbapenem producing Enterobacteriaceae

Abstract

Background: The prevalence of multi-resistant microorganisms is a public health problem that continues to grow globally. There is a population that is mainly susceptible to being colonized and subsequently infected, and these are cancer patients. Aim: To identify the clinical and pathological characteristics of cancer patients and their relationship with infection with ESBL and CPE producing microorganisms. Methods: A retrospective and analytical study was conducted between January 1, 2019 and June 30, 2020 in three hemato-oncological units. Results: We included 3315 patients of which 217 (6.5%) were colonized by microorganisms producing ESBL and CPE. Of these, 106/217 (48.8%) had at least one episode of infection. The most frequently isolated microorganism was Klebsiella pneumoniae 29/106 (27.4%). Of those infected, 18/106 (17%) presented infection by the same colonizing microorganism. Mucositis (P = 0.002), age over 65 years (p = 0.041), hypoalbuminemia (p <0.01), neutropenia (p <0.01) and the presence of invasive devices (p <0.01) demonstrated a relationship with development of infection. The presence of hypoalbuminemia (OR 3.3, CI 1.5-7.1, P <0.01), invasive devices (OR 5.8, CI 3.0-11.4, P <0.01) and neutropenia (OR 4.1, CI 1.5-11.4, P <0.01) predict the development of infections.