Clinical impact of fluoroquinolone-resistant Escherichia coli in the fecal flora of hematological patients with neutropenia and levofloxacin prophylaxis
Fluoroquinolone prophylaxis in patients with neutropenia and hematological malignancies is said to be effective on febrile netropenia (FN)-related infection and mortality; however, the emergence of antibiotic resistance has become a concern. Ciprofloxacin and levofloxacin prophylaxis are most common...
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| creator | Chong, Yong Shimoda, Shinji Yakushiji, Hiroko Ito, Yoshikiyo Aoki, Takatoshi Miyamoto, Toshihiro Kamimura, Tomohiko Shimono, Nobuyuki Akashi, Koichi |
| description | Fluoroquinolone prophylaxis in patients with neutropenia and hematological malignancies is said to be effective on febrile netropenia (FN)-related infection and mortality; however, the emergence of antibiotic resistance has become a concern. Ciprofloxacin and levofloxacin prophylaxis are most commonly recommended. A significant increase in the rate of quinolone-resistant Escherichia coli in fecal flora has been reported following ciprofloxacin prophylaxis. The acquisition of quinolone-resistant E. coli after levofloxacin use has not been evaluated.
We prospectively examined the incidence of quinolone-resistant E. coli isolates recovered from stool cultures before and after levofloxacin prophylaxis in patients with neutropenia from August 2011 to May 2013. Some patients received chemotherapy multiple times.
In this trial, 68 patients were registered. Levofloxacin-resistant E. coli isolates were detected from 11 and 13 of all patients before and after the prophylaxis, respectively. However, this was not statistically significant (P = 0.65). Multiple prophylaxis for sequential chemotherapy did not induce additional quinolone resistance among E. coli isolates. Interestingly, quinolone-resistant E. coli, most of which were extended-spectrum β-lactamase (ESBL) producers, were already detected in approximately 20% of all patients before the initiation of prophylaxis. FN-related bacteremia developed in 2 patients, accompanied by a good prognosis.
Levofloxacin prophylaxis for neutropenia did not result in a significant acquisition of quinolone-resistant E. coli. However, we detected previous colonization of quinolone-resistant E. coli before prophylaxis, which possibly reflects the spread of ESBL. The epidemic spread of resistant E. coli as a local factor may influence strategies toward the use of quinolone prophylaxis. |
| doi_str_mv | 10.1371/journal.pone.0085210 |
| format | Article |
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We prospectively examined the incidence of quinolone-resistant E. coli isolates recovered from stool cultures before and after levofloxacin prophylaxis in patients with neutropenia from August 2011 to May 2013. Some patients received chemotherapy multiple times.
In this trial, 68 patients were registered. Levofloxacin-resistant E. coli isolates were detected from 11 and 13 of all patients before and after the prophylaxis, respectively. However, this was not statistically significant (P = 0.65). Multiple prophylaxis for sequential chemotherapy did not induce additional quinolone resistance among E. coli isolates. Interestingly, quinolone-resistant E. coli, most of which were extended-spectrum β-lactamase (ESBL) producers, were already detected in approximately 20% of all patients before the initiation of prophylaxis. FN-related bacteremia developed in 2 patients, accompanied by a good prognosis.
Levofloxacin prophylaxis for neutropenia did not result in a significant acquisition of quinolone-resistant E. coli. However, we detected previous colonization of quinolone-resistant E. coli before prophylaxis, which possibly reflects the spread of ESBL. The epidemic spread of resistant E. coli as a local factor may influence strategies toward the use of quinolone prophylaxis.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0085210</identifier><identifier>PMID: 24465506</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Aged ; Aged, 80 and over ; Anti-Bacterial Agents - therapeutic use ; Antibiotic resistance ; Antibiotics ; Antimicrobial agents ; Bacteremia ; Beta lactamases ; Biology ; Cancer therapies ; Chemotherapy ; Ciprofloxacin ; Colonization ; Drug Resistance, Bacterial - drug effects ; E coli ; Epidemics ; Escherichia coli ; Escherichia coli - drug effects ; Escherichia coli - isolation & purification ; Escherichia coli - physiology ; Escherichia coli Infections - complications ; Escherichia coli Infections - microbiology ; Escherichia coli Infections - prevention & control ; Evolution & development ; Febrile Neutropenia - complications ; Feces ; Feces - microbiology ; Female ; Flora ; Health aspects ; Hematologic Neoplasms - complications ; Hematology ; Hospitals ; Host-Pathogen Interactions - drug effects ; Humans ; Infection ; Infections ; Infectious diseases ; Klebsiella pneumoniae ; Laboratories ; Levofloxacin ; Levofloxacin - therapeutic use ; Male ; Mathematics ; Medicine ; Microbial drug resistance ; Middle Aged ; Mortality ; Neutropenia ; Neutrophils ; Patients ; Prophylaxis ; Prospective Studies ; Science ; Statistical analysis ; Stem cells ; Transplants & implants ; Treatment Outcome ; University graduates</subject><ispartof>PloS one, 2014-01, Vol.9 (1), p.e85210</ispartof><rights>COPYRIGHT 2014 Public Library of Science</rights><rights>2014 Chong et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2014 Chong et al 2014 Chong et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-5cfb82de1e585b0820fac5f42d4bfb1bf3372590710730721f6f0ab8d4ea067b3</citedby><cites>FETCH-LOGICAL-c692t-5cfb82de1e585b0820fac5f42d4bfb1bf3372590710730721f6f0ab8d4ea067b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3898953/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3898953/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24465506$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chong, Yong</creatorcontrib><creatorcontrib>Shimoda, Shinji</creatorcontrib><creatorcontrib>Yakushiji, Hiroko</creatorcontrib><creatorcontrib>Ito, Yoshikiyo</creatorcontrib><creatorcontrib>Aoki, Takatoshi</creatorcontrib><creatorcontrib>Miyamoto, Toshihiro</creatorcontrib><creatorcontrib>Kamimura, Tomohiko</creatorcontrib><creatorcontrib>Shimono, Nobuyuki</creatorcontrib><creatorcontrib>Akashi, Koichi</creatorcontrib><title>Clinical impact of fluoroquinolone-resistant Escherichia coli in the fecal flora of hematological patients with neutropenia and levofloxacin prophylaxis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Fluoroquinolone prophylaxis in patients with neutropenia and hematological malignancies is said to be effective on febrile netropenia (FN)-related infection and mortality; however, the emergence of antibiotic resistance has become a concern. Ciprofloxacin and levofloxacin prophylaxis are most commonly recommended. A significant increase in the rate of quinolone-resistant Escherichia coli in fecal flora has been reported following ciprofloxacin prophylaxis. The acquisition of quinolone-resistant E. coli after levofloxacin use has not been evaluated.
We prospectively examined the incidence of quinolone-resistant E. coli isolates recovered from stool cultures before and after levofloxacin prophylaxis in patients with neutropenia from August 2011 to May 2013. Some patients received chemotherapy multiple times.
In this trial, 68 patients were registered. Levofloxacin-resistant E. coli isolates were detected from 11 and 13 of all patients before and after the prophylaxis, respectively. However, this was not statistically significant (P = 0.65). Multiple prophylaxis for sequential chemotherapy did not induce additional quinolone resistance among E. coli isolates. Interestingly, quinolone-resistant E. coli, most of which were extended-spectrum β-lactamase (ESBL) producers, were already detected in approximately 20% of all patients before the initiation of prophylaxis. FN-related bacteremia developed in 2 patients, accompanied by a good prognosis.
Levofloxacin prophylaxis for neutropenia did not result in a significant acquisition of quinolone-resistant E. coli. However, we detected previous colonization of quinolone-resistant E. coli before prophylaxis, which possibly reflects the spread of ESBL. 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Ciprofloxacin and levofloxacin prophylaxis are most commonly recommended. A significant increase in the rate of quinolone-resistant Escherichia coli in fecal flora has been reported following ciprofloxacin prophylaxis. The acquisition of quinolone-resistant E. coli after levofloxacin use has not been evaluated.
We prospectively examined the incidence of quinolone-resistant E. coli isolates recovered from stool cultures before and after levofloxacin prophylaxis in patients with neutropenia from August 2011 to May 2013. Some patients received chemotherapy multiple times.
In this trial, 68 patients were registered. Levofloxacin-resistant E. coli isolates were detected from 11 and 13 of all patients before and after the prophylaxis, respectively. However, this was not statistically significant (P = 0.65). Multiple prophylaxis for sequential chemotherapy did not induce additional quinolone resistance among E. coli isolates. Interestingly, quinolone-resistant E. coli, most of which were extended-spectrum β-lactamase (ESBL) producers, were already detected in approximately 20% of all patients before the initiation of prophylaxis. FN-related bacteremia developed in 2 patients, accompanied by a good prognosis.
Levofloxacin prophylaxis for neutropenia did not result in a significant acquisition of quinolone-resistant E. coli. However, we detected previous colonization of quinolone-resistant E. coli before prophylaxis, which possibly reflects the spread of ESBL. The epidemic spread of resistant E. coli as a local factor may influence strategies toward the use of quinolone prophylaxis.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>24465506</pmid><doi>10.1371/journal.pone.0085210</doi><tpages>e85210</tpages><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_plos_journals_1491120427 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Aged Aged, 80 and over Anti-Bacterial Agents - therapeutic use Antibiotic resistance Antibiotics Antimicrobial agents Bacteremia Beta lactamases Biology Cancer therapies Chemotherapy Ciprofloxacin Colonization Drug Resistance, Bacterial - drug effects E coli Epidemics Escherichia coli Escherichia coli - drug effects Escherichia coli - isolation & purification Escherichia coli - physiology Escherichia coli Infections - complications Escherichia coli Infections - microbiology Escherichia coli Infections - prevention & control Evolution & development Febrile Neutropenia - complications Feces Feces - microbiology Female Flora Health aspects Hematologic Neoplasms - complications Hematology Hospitals Host-Pathogen Interactions - drug effects Humans Infection Infections Infectious diseases Klebsiella pneumoniae Laboratories Levofloxacin Levofloxacin - therapeutic use Male Mathematics Medicine Microbial drug resistance Middle Aged Mortality Neutropenia Neutrophils Patients Prophylaxis Prospective Studies Science Statistical analysis Stem cells Transplants & implants Treatment Outcome University graduates |
| title | Clinical impact of fluoroquinolone-resistant Escherichia coli in the fecal flora of hematological patients with neutropenia and levofloxacin prophylaxis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-02T21%3A34%3A39IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Clinical%20impact%20of%20fluoroquinolone-resistant%20Escherichia%20coli%20in%20the%20fecal%20flora%20of%20hematological%20patients%20with%20neutropenia%20and%20levofloxacin%20prophylaxis&rft.jtitle=PloS%20one&rft.au=Chong,%20Yong&rft.date=2014-01-22&rft.volume=9&rft.issue=1&rft.spage=e85210&rft.pages=e85210-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0085210&rft_dat=%3Cgale_plos_%3EA478854515%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1491120427&rft_id=info:pmid/24465506&rft_galeid=A478854515&rft_doaj_id=oai_doaj_org_article_700611b6b74a47719f96a4692dda26dc&rfr_iscdi=true |