ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Colonization With Fluoroquinolone-Resistant Enterobacterales Decreases the Effectiveness of Fluoroquinolone Prophylaxis in Hematopoietic Cell Transplant Recipients.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05824689 (Exploratory Study of Fluoroquinolone Resistance for Patients Undergoing Autologous Hematopoietic Stem Cell), which is not on this map. Cited by 32 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Exploratory Study of Fluoroquinolone Resistance for Patients Undergoing Autologous Hematopoietic Stem Cell (HSC) Transplantation in the Treatment of Multiple Myeloma
Who cites it
32 citing papers in PubMed, 49 citations in OpenAlex.
- Coming Into Resistance: Clinically Important Antibiotic Resistance Genes in NICU vs. Healthy Infants.medRxiv : the preprint server for health sciences · 2026Article
- Colonization with extended-spectrum and AmpC β-lactamase-producing Enterobacterales and bacteremia risk in patients with acute leukemia who receive induction chemotherapy without fluoroquinolone prophylaxis.Antimicrobial agents and chemotherapy · 2026Article
- Determinants of levofloxacin prophylaxis failure in high-risk haematology patients: a prospective study integrating resistant colonization and pharmacokinetic/pharmacodynamic target attainment.The Journal of antimicrobial chemotherapy · 2026Article
- Fluoroquinolone Prophylaxis Uncovers High Prevalence Rates of Fluoroquinolone-ResistantCancers · 2026Article
- Antibacterial prophylaxis and antimicrobial stewardship in the era of innovative therapies for haematological malignancies: transplantation, cellular therapies and new drugs.JAC-antimicrobial resistance · 2026Review
- Descriptive analysis of frequency and antimicrobial susceptibility of pathogens isolated from acute leukemia patients with febrile neutropenia over a four-year period at a tertiary hospital.BMC infectious diseases · 2026Article
- Article
- The impact of fluoroquinolone-resistant enterobacterales colonization on fluoroquinolone prophylaxis efficacy in hematopoietic cell transplant recipients.BMC infectious diseases · 2025Article
- Update on infection prevention in the ICU.Current opinion in critical care · 2025Review
- Can We Lower the Burden of Antimicrobial Resistance (AMR) in Heavily Immunocompromised Patients? A Narrative Review and Call to Action.Infectious diseases and therapy · 2025Review
- The Impact of Antibiotic Prophylaxis on Antibiotic Resistance, Clinical Outcomes, and Costs in Adult Hemato-Oncological and Surgical Patients: A Systematic Review and Meta-Analysis.Antibiotics (Basel, Switzerland) · 2025Review
- Article
- Contemporary review of critical illness following allogeneic hematopoietic stem cell transplant in adults.Intensive care medicine · 2025Review
- The Prevalence of Multidrug Resistance in Enterobacterales Is Higher in Patients Undergoing Hematopoietic Stem Cell Transplantation.Open forum infectious diseases · 2025Article
- Management of febrile neutropenia: consensus of the Brazilian Association of Hematology, Blood Transfusion and Cell Therapy - ABHH.Hematology, transfusion and cell therapy · 2024Article
- Pre-engraftment bacteremia after allogeneic hematopoietic cell transplantation without primary fluoroquinolone antibacterial prophylaxis.Transplant infectious disease : an official journal of the Transplantation Society · 2024Observational
- Review
- Patterns of fluoroquinolone utilization and resistance in a tertiary care hospital: a retrospective cross-sectional analysis study from a developing country.BMC infectious diseases · 2024Article
- Engineered phage with antibacterial CRISPR-Cas selectively reduce E. coli burden in mice.Nature biotechnology · 2024Article
- Global impact of antibacterial resistance in patients with hematologic malignancies and hematopoietic cell transplant recipients.Transplant infectious disease : an official journal of the Transplantation Society · 2023Review
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Authors and funding
18 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundLevofloxacin prophylaxis is recommended to prevent gram-negative bloodstream infections (BSIs) in patients with prolonged chemotherapy-induced neutropenia. However, increasing fluoroquinolone resistance may decrease the effectiveness of this approach.
methodsWe assessed the prevalence of colonization with fluoroquinolone-resistant Enterobacterales (FQRE) among patients admitted for hematopoietic cell transplantation (HCT) from November 2016 to August 2019 and compared the risk of gram-negative BSI between FQRE-colonized and noncolonized patients. All patients received levofloxacin prophylaxis during neutropenia. Stool samples were collected upon admission for HCT and weekly thereafter until recovery from neutropenia, and underwent selective culture for FQRE. All isolates were identified and underwent antimicrobial susceptibility testing by broth microdilution. FQRE isolates also underwent whole-genome sequencing.
resultsFifty-four of 234 (23%) patients were colonized with FQRE prior to HCT, including 30 of 119 (25%) allogeneic and 24 of 115 (21%) autologous HCT recipients. Recent antibacterial use was associated with FQRE colonization (P = .048). Ninety-one percent of colonizing FQRE isolates were Escherichia coli and 29% produced extended-spectrum β-lactamases. Seventeen (31%) FQRE-colonized patients developed gram-negative BSI despite levofloxacin prophylaxis, compared to only 2 of 180 (1.1%) patients who were not colonized with FQRE on admission (P < .001). Of the 17 gram-negative BSIs in FQRE-colonized patients, 15 (88%) were caused by FQRE isolates that were genetically identical to the colonizing strain.
conclusionsNearly one-third of HCT recipients with pretransplant FQRE colonization developed gram-negative BSI while receiving levofloxacin prophylaxis, and infections were typically caused by their colonizing strains. In contrast, levofloxacin prophylaxis was highly effective in patients not initially colonized with FQRE.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.