Epidemiology and risk factors associated to bacterial resistance in solid organ cancer (SOC) patients has been barely described. This retrospective monocentric study analyzed clinical variables in SOC patients who developed bacteremia between 1 January 2019 and 31 December 2022. We described rates of bacterial resistance in Gram negative bacteria (80.6%):E. coli-ESBL, K. pneumoniae-ESBL, Carbapenem-ResistantK. pneumoniaeand Meropenem-ResistantP. aeruginosa,as well as antibiotic consumption, and compared these rates between the medical and oncology wards. In total, we included 314 bacteremias from 253 patients. SOC patients are frequently prescribed antibiotics (40.8%), mainly fluoroquinolones. Nosocomial bacteremia accounted for 18.2% of the cases and only 14.3% of patients were neutropenic. Hepatobiliary tract was the most frequent tumor (31.5%) and source of bacteremia (38.5%). Resistant bacteria showed a decreased rate of resistance during the years studied in the oncology ward. Both K-ESBL and K-CBP resistance rates decreased (from 45.8% to 20.0%, and from 29.2% to 20.0%, respectively), as well as MRPA, which varied from a resistance rate of 28% to 16.7%. The presence of a urinary catheter (p< 0.001) and previous antibiotic prescription (p= 0.002) were risk factors for bacterial resistance. Identifying either of these risk factors could help in guiding antibiotic prescription for SOC patients.
实体器官肿瘤（SOC）患者中细菌耐药性的流行病学及相关危险因素尚缺乏充分描述。本项回顾性单中心研究分析了2019年1月1日至2022年12月31日期间发生菌血症的SOC患者的临床变量。我们重点描述了革兰氏阴性菌（占80.6%）的耐药率情况：包括产超广谱β-内酰胺酶大肠杆菌、产超广谱β-内酰胺酶肺炎克雷伯菌、碳青霉烯类耐药肺炎克雷伯菌及美罗培南耐药铜绿假单胞菌，同时统计了抗生素使用情况，并比较了内科病房与肿瘤科病房之间的差异。研究共纳入253名患者的314例菌血症事件。SOC患者抗生素使用频繁（40.8%），以氟喹诺酮类药物为主。医院获得性菌血症占18.2%，仅14.3%患者出现中性粒细胞减少。肝胆道肿瘤是最常见的肿瘤类型（31.5%）及菌血症来源（38.5%）。肿瘤科病房的耐药菌株在观察年份中呈现下降趋势：产ESBL肺炎克雷伯菌与碳青霉烯类耐药肺炎克雷伯菌的耐药率分别从45.8%降至20.0%、29.2%降至20.0%，美罗培南耐药铜绿假单胞菌的耐药率也从28%下降至16.7%。留置导尿管（p<0.001）与既往抗生素使用史（p=0.002）是细菌耐药性的危险因素。识别这些危险因素有助于指导SOC患者的抗生素合理应用。
肿瘤(癌症)患者之家