Colonization with multi-drug-resistant organisms negatively impacts survival in patients with non-small cell lung cancer.
Colonization with multi-drug-resistant organisms negatively impacts survival in patients with non-small cell lung cancer.
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DOI：
10.1371/journal.pone.0242544
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发表时间：
2020
期刊：
影响因子：
3.7
通讯作者：
Koschade S
中科院分区：
文献类型：
--
作者：
Stratmann JA;Lacko R;Ballo O;Shaid S;Gleiber W;Vehreschild MJGT;Wichelhaus T;Reinheimer C;Göttig S;Kempf VAJ;Kleine P;Stera S;Brandts C;Sebastian M;Koschade S
耐多药生物（MDRO）被认为是世界范围内的新威胁。然而，关于MDRO定植在实体恶性肿瘤患者中的临床影响的数据却普遍缺失。我们试图确定MDRO定殖对已知具有侵袭性感染高风险的非小细胞肺癌（NSCLC）患者的影响。在所有分期NSCLC诊断后90天内进行MDRO定植筛查的患者被纳入这项单中心回顾性研究。纳入295例患者，其中24例（8.1%）首次诊断时MDRO定植（MDROpos）筛查阳性。MDRO检出最多的是肠杆菌，占79.2%（19/24）。MDRO定植存在于所有疾病阶段，在合并糖尿病患者中更常见。在单因素分析（p = 0.036）和多因素分析（p = 0.02）中，MDROpos研究组的中位总生存期显著低于MDROpos组，中位总生存期为7.8个月（95% CI, 0.0-19.9个月），而MDROpos组的中位总生存期为23.9个月（95% CI, 17.6-30.1个月）。探索性分析表明，与MDROpos患者相比，MDROpos患者的非癌症相关死亡率更高（p = 0.002）， MDROpos患者的致命感染率增加（p = 0.0002）。由于较高的致死性感染率，MDRO定植是诊断为NSCLC的患者发生不良OS的独立危险因素。经验性抗生素治疗方法应涵盖（疑似）侵袭性感染病例中以前检测到的耐多药共生菌。
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. 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. 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). 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.
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影响因子：
2.8
作者：
Engler-Hüsch S;Heister T;Mutters NT;Wolff J;Kaier K
通讯作者：
Kaier K
影响因子：
11.8
作者：
Goettig, Stephan;Gruber, Teresa M.;Kempf, Volkhard A. J.
通讯作者：
Kempf, Volkhard A. J.
影响因子：
1.6
作者：
Al-Otaibi, Fawzia E.;Bukhari, Elham E.;Alrabiaa, Abdulkarim A.
通讯作者：
Alrabiaa, Abdulkarim A.
影响因子：
1.9
作者：
Gedik, Habip;Yildirmak, Taner;Arabaci, Cigdem
通讯作者：
Arabaci, Cigdem
影响因子：
6.7
作者：
Leavis HL;Willems RJ;van Wamel WJ;Schuren FH;Caspers MP;Bonten MJ
通讯作者：
Bonten MJ