Molecular epidemiology and antimicrobial resistance profiles of causing bloodstream infections in neutropenic cancer patients

BACKGROUND: Bloodstream infections (BSI) in neutropenic cancer patients, particularly those caused by (PA), are associated with high morbidity and mortality. The increasing prevalence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) PA strains complicates clinical management. This s...

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Autores: Cadenas-Jiménez, Irene, Badía-Tejero, Ana María, López-Causapé, Carla, Morosini, María-Isabel, Portillo-Calderón, Inés, Machado, Marina, Larrosa, Nieves, Dávila, Piluca Martín, Palacios-Baena, Zaira, Puig-Albasanz, Adaia, Tubau, Fe, Oliver, Antonio, Sastre, Enric, Martí, Sara, Gudiol, Carlota
Formato: artículo
Fecha de publicación:2025
País:España
Recursos:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:docusalut.com:20.500.13003/26124
Acesso em linha:https://hdl.handle.net/20.500.13003/26124
Access Level:acceso abierto
Palavra-chave:Pseudomonas aeruginosa
Bacteremia
Neoplasms
Drug Resistance
Drug Resistance, Multiple, Bacterial
Neutropenia
Virulence Factors
Bacteriemia
Neoplasias
Resistencia a Medicamentos
Farmacorresistencia Bacteriana Múltiple
Factores de Virulencia
bacteraemia
bloodstream infection
cancer
multidrug resistance
neutropenia
virulence factors
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spelling Molecular epidemiology and antimicrobial resistance profiles of causing bloodstream infections in neutropenic cancer patientsCadenas-Jiménez, IreneBadía-Tejero, Ana MaríaLópez-Causapé, CarlaMorosini, María-IsabelPortillo-Calderón, InésMachado, MarinaLarrosa, NievesDávila, Piluca MartínPalacios-Baena, ZairaPuig-Albasanz, AdaiaTubau, FeOliver, AntonioSastre, EnricMartí, SaraGudiol, CarlotaPseudomonas aeruginosaBacteremiaNeoplasmsDrug ResistanceDrug Resistance, Multiple, BacterialNeutropeniaVirulence FactorsPseudomonas aeruginosaBacteriemiaNeoplasiasResistencia a MedicamentosFarmacorresistencia Bacteriana MúltipleNeutropeniaFactores de VirulenciaPseudomonas aeruginosabacteraemiabloodstream infectioncancermultidrug resistanceneutropeniavirulence factorsBACKGROUND: Bloodstream infections (BSI) in neutropenic cancer patients, particularly those caused by (PA), are associated with high morbidity and mortality. The increasing prevalence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) PA strains complicates clinical management. This study aimed to characterise PA strains causing BSI in neutropenic cancer patients and assess the association between microbiological features and clinical outcomes. METHODS: We analysed PA strains from 94 BSI episodes in neutropenic cancer patients across five Spanish hospitals (2006-2018). Antimicrobial resistance, alginate and pigment production were assessed. Whole-genome sequencing was performed to identify resistance mutations and virulence genes. RESULTS: PA strains exhibited high genetic diversity, with ST175 as the most prevalent clone (28.7%). MDR non-XDR and XDR strains accounted for 10.3% and 18.1% of cases, respectively. The highest resistance rates were for ciprofloxacin (42.6%) and imipenem (36.2%). Resistance was primarily driven by chromosomal mutations. ExoU was present in 24.4% of strains, associated with serotype O11 and ST253. Seven-day and 30-day mortality were 21.3% and 31.9%, respectively. Mortality was not significantly influenced by resistance phenotypes or the presence of ExoU. Polymicrobial infection ( = 0.016), septic shock ( < 0.001), Intensive Care Unit admission ( = 0.002), and inadequate empirical antibiotic therapy ( = 0.002), were linked to increased 7-day mortality. CONCLUSION: ST175 was the dominant high-risk clone, associated with antimicrobial resistance, while virulence traits were more common in susceptible strains. Inadequate empirical antibiotic therapy and septic shock significantly impacted early 7-day mortality, underscoring the need for early diagnosis and optimised treatment strategies.Frontiers20252025-01-0120252025-01-01research articlehttp://purl.org/coar/resource_type/c_2df8fbb1info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/20.500.13003/26124reponame:Docusalutinstname:Conselleria de Salut i Consum del Govern de les Illes BalearsInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:docusalut.com:20.500.13003/261242026-06-22T12:44:07Z
dc.title.none.fl_str_mv Molecular epidemiology and antimicrobial resistance profiles of causing bloodstream infections in neutropenic cancer patients
title Molecular epidemiology and antimicrobial resistance profiles of causing bloodstream infections in neutropenic cancer patients
spellingShingle Molecular epidemiology and antimicrobial resistance profiles of causing bloodstream infections in neutropenic cancer patients
Cadenas-Jiménez, Irene
Pseudomonas aeruginosa
Bacteremia
Neoplasms
Drug Resistance
Drug Resistance, Multiple, Bacterial
Neutropenia
Virulence Factors
Pseudomonas aeruginosa
Bacteriemia
Neoplasias
Resistencia a Medicamentos
Farmacorresistencia Bacteriana Múltiple
Neutropenia
Factores de Virulencia
Pseudomonas aeruginosa
bacteraemia
bloodstream infection
cancer
multidrug resistance
neutropenia
virulence factors
title_short Molecular epidemiology and antimicrobial resistance profiles of causing bloodstream infections in neutropenic cancer patients
title_full Molecular epidemiology and antimicrobial resistance profiles of causing bloodstream infections in neutropenic cancer patients
title_fullStr Molecular epidemiology and antimicrobial resistance profiles of causing bloodstream infections in neutropenic cancer patients
title_full_unstemmed Molecular epidemiology and antimicrobial resistance profiles of causing bloodstream infections in neutropenic cancer patients
title_sort Molecular epidemiology and antimicrobial resistance profiles of causing bloodstream infections in neutropenic cancer patients
dc.creator.none.fl_str_mv Cadenas-Jiménez, Irene
Badía-Tejero, Ana María
López-Causapé, Carla
Morosini, María-Isabel
Portillo-Calderón, Inés
Machado, Marina
Larrosa, Nieves
Dávila, Piluca Martín
Palacios-Baena, Zaira
Puig-Albasanz, Adaia
Tubau, Fe
Oliver, Antonio
Sastre, Enric
Martí, Sara
Gudiol, Carlota
author Cadenas-Jiménez, Irene
author_facet Cadenas-Jiménez, Irene
Badía-Tejero, Ana María
López-Causapé, Carla
Morosini, María-Isabel
Portillo-Calderón, Inés
Machado, Marina
Larrosa, Nieves
Dávila, Piluca Martín
Palacios-Baena, Zaira
Puig-Albasanz, Adaia
Tubau, Fe
Oliver, Antonio
Sastre, Enric
Martí, Sara
Gudiol, Carlota
author_role author
author2 Badía-Tejero, Ana María
López-Causapé, Carla
Morosini, María-Isabel
Portillo-Calderón, Inés
Machado, Marina
Larrosa, Nieves
Dávila, Piluca Martín
Palacios-Baena, Zaira
Puig-Albasanz, Adaia
Tubau, Fe
Oliver, Antonio
Sastre, Enric
Martí, Sara
Gudiol, Carlota
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv
dc.subject.none.fl_str_mv Pseudomonas aeruginosa
Bacteremia
Neoplasms
Drug Resistance
Drug Resistance, Multiple, Bacterial
Neutropenia
Virulence Factors
Pseudomonas aeruginosa
Bacteriemia
Neoplasias
Resistencia a Medicamentos
Farmacorresistencia Bacteriana Múltiple
Neutropenia
Factores de Virulencia
Pseudomonas aeruginosa
bacteraemia
bloodstream infection
cancer
multidrug resistance
neutropenia
virulence factors
topic Pseudomonas aeruginosa
Bacteremia
Neoplasms
Drug Resistance
Drug Resistance, Multiple, Bacterial
Neutropenia
Virulence Factors
Pseudomonas aeruginosa
Bacteriemia
Neoplasias
Resistencia a Medicamentos
Farmacorresistencia Bacteriana Múltiple
Neutropenia
Factores de Virulencia
Pseudomonas aeruginosa
bacteraemia
bloodstream infection
cancer
multidrug resistance
neutropenia
virulence factors
description BACKGROUND: Bloodstream infections (BSI) in neutropenic cancer patients, particularly those caused by (PA), are associated with high morbidity and mortality. The increasing prevalence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) PA strains complicates clinical management. This study aimed to characterise PA strains causing BSI in neutropenic cancer patients and assess the association between microbiological features and clinical outcomes. METHODS: We analysed PA strains from 94 BSI episodes in neutropenic cancer patients across five Spanish hospitals (2006-2018). Antimicrobial resistance, alginate and pigment production were assessed. Whole-genome sequencing was performed to identify resistance mutations and virulence genes. RESULTS: PA strains exhibited high genetic diversity, with ST175 as the most prevalent clone (28.7%). MDR non-XDR and XDR strains accounted for 10.3% and 18.1% of cases, respectively. The highest resistance rates were for ciprofloxacin (42.6%) and imipenem (36.2%). Resistance was primarily driven by chromosomal mutations. ExoU was present in 24.4% of strains, associated with serotype O11 and ST253. Seven-day and 30-day mortality were 21.3% and 31.9%, respectively. Mortality was not significantly influenced by resistance phenotypes or the presence of ExoU. Polymicrobial infection ( = 0.016), septic shock ( < 0.001), Intensive Care Unit admission ( = 0.002), and inadequate empirical antibiotic therapy ( = 0.002), were linked to increased 7-day mortality. CONCLUSION: ST175 was the dominant high-risk clone, associated with antimicrobial resistance, while virulence traits were more common in susceptible strains. Inadequate empirical antibiotic therapy and septic shock significantly impacted early 7-day mortality, underscoring the need for early diagnosis and optimised treatment strategies.
publishDate 2025
dc.date.none.fl_str_mv 2025
2025-01-01
2025
2025-01-01
dc.type.none.fl_str_mv research article
http://purl.org/coar/resource_type/c_2df8fbb1
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.13003/26124
url https://hdl.handle.net/20.500.13003/26124
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Frontiers
publisher.none.fl_str_mv Frontiers
dc.source.none.fl_str_mv reponame:Docusalut
instname:Conselleria de Salut i Consum del Govern de les Illes Balears
instname_str Conselleria de Salut i Consum del Govern de les Illes Balears
reponame_str Docusalut
collection Docusalut
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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