In:
PLOS ONE, Public Library of Science (PLoS), Vol. 15, No. 11 ( 2020-11-25), p. e0242544-
Abstract:
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. Materials and methods 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. Results Two hundred and ninety-five patients were included of whom 24 patients (8.1%) were screened positive for MDRO colonization (MDRO pos ) 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 MDRO pos 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 MDRO neg group in univariate (p = 0.036) and multivariate analysis (P = 0.02). Exploratory analyses suggest a higher rate of non-cancer-related-mortality in MDRO pos patients compared to MDRO neg patients (p = 0.002) with an increased rate of fatal infections in MDRO pos patients (p = 0.0002). Conclusions 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.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0242544
DOI:
10.1371/journal.pone.0242544.g001
DOI:
10.1371/journal.pone.0242544.g002
DOI:
10.1371/journal.pone.0242544.g003
DOI:
10.1371/journal.pone.0242544.g004
DOI:
10.1371/journal.pone.0242544.t001
DOI:
10.1371/journal.pone.0242544.t002
DOI:
10.1371/journal.pone.0242544.s001
DOI:
10.1371/journal.pone.0242544.s002
DOI:
10.1371/journal.pone.0242544.s003
DOI:
10.1371/journal.pone.0242544.s004
DOI:
10.1371/journal.pone.0242544.r001
DOI:
10.1371/journal.pone.0242544.r002
DOI:
10.1371/journal.pone.0242544.r003
DOI:
10.1371/journal.pone.0242544.r004
DOI:
10.1371/journal.pone.0242544.r005
DOI:
10.1371/journal.pone.0242544.r006
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2020
detail.hit.zdb_id:
2267670-3
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