ArticleMicrobiology spectrum2023
High Rate of Inappropriate Antibiotics in Patients with Hematologic Malignancies and Pseudomonas aeruginosa Bacteremia following International Guideline Recommendations.
Article in Microbiology spectrum, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 22 citations in OpenAlex.
- Global epidemiology of carbapenem-resistantJAC-antimicrobial resistance · 2026Review
- Impact of corticosteroids on lung antibiotic resistance genes in patients with lower respiratory tract infections.Microbiology spectrum · 2026Article
- Assessing appropriateness of antibiotic therapy: a scoping review of definitions and their clinical implication.Infection · 2026Article
- Antibiotic therapy in febrile neutropenia in haematological patients: current considerations and future challenges.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2026Review
- Epidemiology and Characteristics of Antibiotic Resistance of ESKAPE andInfection and drug resistance · 2026Article
- Retrospective Evaluation of the Incidence, Clinical Characteristics and Outcomes of Gram-Negative Bacterial Infections in Patients with Hematologic Malignancies.Pathogens (Basel, Switzerland) · 2025Article
- Therapeutic approach in the critically ill patient with suspected multidrug resistance.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2025Review
- Effect of guideline-concordant, appropriate, and effective antimicrobial treatment on patient outcome in multidrug-resistant (MDR) infections.Microbiology spectrum · 2025Article
- 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
- Effectiveness and safety of cefiderocol treatment in patients with Gram-negative bacterial infections in Spain in the early access programme: results of the PERSEUS study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Article
- CombattingAntibiotics (Basel, Switzerland) · 2025Review
- Multicenter Surveillance ofInfection and drug resistance · 2025Article
- Development and Validation of a Machine Learning Model for the Prediction of Bloodstream Infections in Patients with Hematological Malignancies and Febrile Neutropenia.Antibiotics (Basel, Switzerland) · 2024Article
- Epidemiology of Bacteremia in Patients with Hematological Malignancies and Hematopoietic Stem Cell Transplantation and the Impact of Antibiotic Resistance on Mortality: Data from a Multicenter Study in Argentina.Pathogens (Basel, Switzerland) · 2024Observational
- Evaluation of the quickmic system in the rapid diagnosis of Gram-negative bacilli bacteremia.Microbiology spectrum · 2024Article
- Adult acute leukemia patients with gram-negative bacteria bloodstream infection: Risk factors and outcomes of antibiotic-resistant bacteria.Annals of hematology · 2024Article
- Predicting early appropriate therapy for patients infected by carbapenem-resistant Gram-negative pathogens in intensive care units in Italy.Antimicrobial resistance and infection control · 2024Article
- Impact of multidrug resistance on the virulence and fitness of Pseudomonas aeruginosa: a microbiological and clinical perspective.Infection · 2024Review
- Article
- 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
22 authors at 16 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Optimal coverage of Pseudomonas aeruginosa is challenging in febrile neutropenic patients due to a progressive increase in antibiotic resistance worldwide. We aimed to detail current rates of resistance to antibiotics recommended by international guidelines for P. aeruginosa isolated from bloodstream infections (BSI) in patients with hematologic malignancies. Secondarily, we aimed to describe how many patients received inappropriate empirical antibiotic treatment (IEAT) and its impact on mortality. We conducted a retrospective, multicenter cohort study of the last 20 BSI episodes caused by P. aeruginosa in patients with hematologic malignancies from across 14 university hospitals in Spain. Of the 280 patients with hematologic malignancies and BSI caused by P. aeruginosa, 101 (36%) had strains resistant to at least one of the β-lactam antibiotics recommended in international guidelines, namely, cefepime, piperacillin-tazobactam, and meropenem. Additionally, 21.1% and 11.4% of the strains met criteria for MDR and XDR P. aeruginosa, respectively. Even if international guidelines were followed in most cases, 47 (16.8%) patients received IEAT and 66 (23.6%) received inappropriate β-lactam empirical antibiotic treatment. Thirty-day mortality was 27.1%. In the multivariate analysis, pulmonary source (OR 2.22, 95% CI 1.14 to 4.34) and IEAT (OR 2.67, 95% CI 1.37 to 5.23) were factors independently associated with increased mortality. We concluded that P. aeruginosa-causing BSI in patients with hematologic malignancies is commonly resistant to antibiotics recommended in international guidelines, which is associated with frequent IEAT and higher mortality. New therapeutic strategies are needed.
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