Abstract
Carbapenem-resistant Acinetobacter baumannii (CRAB) is one of the most commonly reported nosocomial infections in cancer patients and could be fatal because of suboptimal immune defenses in these patients. We aimed to compare clinical response, microbiological response, nephrotoxicity, and 30-day mortality between cancer patients who received short (<14 days) and long (≥14 days) courses of colistin for treatment of CRAB infection. A retrospective cohort study was conducted in cancer patients with CRAB infection who received short or long courses of colistin between 2015 to 2017 at Chiang Mai University Hospital (CMUH). A total of 128 patients met the inclusion criteria. The results of this study show that patients who received long course of colistin therapy had a higher rate of clinical response; adjusted odds ratio (OR) was 3.16 times in patients receiving long-course colistin therapy (95%CI, 1.37–7.28; p value = 0.007). Microbiological response in patients with long course was 4.65 times (adjusted OR) higher than short course therapy (95%CI, 1.72–12.54; p value = 0.002). Moreover, there was no significant difference in nephrotoxicity (adjusted OR, 0.91, 95%CI, 0.39–2.11; p value = 0.826) between the two durations of therapy. Thirty-day mortality in the long-course therapy group was 0.11 times (adjusted OR) compared to the short-course therapy group (95%CI, 0.03–0.38; p value = 0.001). Propensity score analyses also demonstrated similar results. In conclusion, cancer patients who received a long course of colistin therapy presented greater clinical and microbiological responses and lower 30-day mortality but similar nephrotoxicity as compared with those who a received short course. Therefore, a long course of colistin therapy should be considered for management of CRAB infection in cancer patients.
Highlights
Patients with cancer are at-risk of infections caused by antibiotic resistant Gramnegative bacteria
One hundred and twenty-eight cancer patients with carbapenem-resistant A. baumannii (CRAB) infection were recruited in the study; there were 84 patients in the short course and 44 patients in the long course of colistin therapy
Patients in the short and long courses of colistin therapy were comparable in most baseline demographics and clinical characteristics, the numbers of patient in both group were different (Table 1)
Summary
Patients with cancer are at-risk of infections caused by antibiotic resistant Gramnegative bacteria. Acinetobacter baumannii is one of the most commonly reported nosocomial infections in cancer patients [1]. A. baumannii has been identified in patients with solid tumors, hematological malignancies, neutropenia, and those in the Intensive Care Unit (ICU) [2,3,4]. Infections caused by A. baumannii can be fatal in patients with suboptimal immune defenses, especially cancer patients [1,2]. The prevalence and mortality rate of carbapenem-resistant A. baumannii (CRAB) has increased. The mortality rate of patients with cancer and multidrug-resistant (MDR) A. baumannii infection has reached 55% [5]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
