Surveillance of fecal carriage of carbapenemase-producing gram-negative bacilli in onco-hematological patients

Abstract

Introduction: Infection with carbapenemase-producing Gram-negative bacilli (CP-GNB) carries high morbidity and mortality in cancer patients, and intestinal colonization is a risk factor. Objective: To estimate the prevalence of rectal carriage and the risk of infection with CP-GNB in cancer patients. Methodology: Positive microbiological results (carriage and culture of clinical samples) for CP-GNB were reviewed in cancer patients hospitalized between January 2023 and June 2024. The relationship between rectal carriage and the subsequent onset of clinical infections was assessed with a chi-square test and a bivariate logistic regression model. Results: Of 2,172 patients, 149 (6.9%) were carriers of CP-GNB, with no differences according to cancer type. Of these, 13.4% developed an infection vs. 1.2% of those not colonized (p ≤0.001); this was significantly associated with a higher risk of clinical infection (OR=12.39; 95% CI: 6.7-22.9; p≤0.001). Discussion: Colonization with CP-GNB was a significant risk for developing clinical infection in cancer patients in our institution, regardless of the cancer type. Carriage surveillance is essential for stratifying individual infection risk and optimizing antimicrobial treatment.