PERCENTAGE OF CIPROFLOXACIN-RESISTANT STRAINS OF CITROBACTER FREUNDII IN ACUTE LEUKAEMIA PATIENTS WITH CIPROFLOXACIN PROPHYLAXIS

  • Rika Strauch Klinični oddelek za hematologijo SPS Interna klinika Klinični center Zaloška 7 1525 Ljubljana
  • Alenka Andlovic Inštitut za mikrobiologijo in imunologijo Medicinska fakulteta Zaloška 4 Ljubljana
  • Peter Černelč Klinični oddelek za hematologijo SPS Interna klinika Klinični center Zaloška 7 1525 Ljubljana
Keywords: surveillance bacterial cultures, enterobacteria, multi-resistant strains, extended-spectrum beta-lactamases (ESBL)

Abstract

Background. Authors tried to determine an efficiency of ciprofloxacin as infection prophylaxis in patients with acute leukaemia treated at the Department of Haematology in Clinical Center of Ljubljana. Due to cytotoxic chemotherapy, aplasia of bone marrow is inevitable. Therefore, these patients are at high risk for bacterial and fungal infection. The authors have noticed a rise in the number of ciprofloxacin-resistant strains of Citrobacter freundii and decided to find out if ciprofloxacin is still usable in this setting.

Patients and methods. 45 patients with acute leukaemia were admitted to the Department of Haematology in the Clinical Center of Ljubljana during the year 2001 and 2002. All the patients received ciprofloxacin 2 × 500 mg on a daily basis. Citrobacter freundii was isolated in 11 patients, to whom we determined the proportion of ciprofloxacin-resistant strains of Citrobacter freundii and other Enterobacteriaceae. Susceptibility testing was done by the NCCCLS standards by the disc diffusion method and minimal inhibitory concentration.

Results. C. freundii was isolated in 11 patients with AL. Extended-spectrum beta-lactamases (ESBL) C. freundii was isolated in 6 patients (54.5%). Ciprofloxacin-resistant C. freundii was isolated in 6 patients (54.5%). Six patients (54.5%) had ciprofloxacin-resistant C. freundii which was ESBL positive at the same time. In AL patients with C. freundii (n = 11) almost half of isolated bacteria were Gram negative bacilli (45.2%, n = 292), mostly from the family of Enterobacteriaceae. More than half of enterobacteria were ciprofloxacin-resistant, one third of them were also ESBL positive. Out of 131 enterobacteria, C. freundii was isolated 37 times. (28.2%).

Conclusions. C. freundii was isolated in one fourth of AL patients. Half of the isolates were ciprofloxacin-resistant. The same was true for isolated enterobacteria. Almost all of ciprofloxacin-resistant bacteria were ESBL positive. There is a question whether ciprofloxacin prophylaxis still remains an efficient method.



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References

Pizzo A. Considerations for the prevention of infectious complications in patients with cancer. Rev Infect Dis 1989; 11: Suppl 7: 1551–63.

Ambrosino DM, Molrine DC. Critical appraisal of immunisation strategies for preventions of infection in the compromised host. Hematol Oncol Clin North Am 1993; 7: 1027–7.

Elting LS. Outcomes of bacteremia in patients with cancer and neutropenia: Observations of two decades of epidemiological clinical trials. Clin J Infect Dis 1997; 25: 247–7.

Liassine N, Bille J, Breer C, Frei R, Wust J, Auckentaker R. In vitro activity of cefpirome against microorganisms isolated in haematology, oncology and intensive care units in Switzerland. Scand J Infect Dis 1997; 29 (6): 615–21.

Čižman M, Gubina M, Pokorn M, Tomič V. Monoterapija ali kombinacija antibiotikov v zdravljenju febrilne nevtropenije. Med Razgl 1996; 35 Suppl: 7: 71–85.

Martinez-Martinez L, Suarez AI, Carranza R, Perea EJ. Ciprofloxacin resistance in gram-negative bacilli. Epidemiologoc aspects. Enferm Infecc Microbiol Clin 1993; 11 (9): 474–8.

Sirot J, Nicolas-Chanoine MH, Chardon H, Avril JL, Cattoen C, Coix JC. Susceptibility of Enterobacteriaceae to beta-lactem agents and fluoroquinolones: a 3-year survey in France. Clin Microbiol Infect 2002; 8 (4): 207–13.

Černelč P. Preprečevanje okužb pri bolnikih s hudo nevtropenijo. Med Razgl 1996; 35: Suppl 7: 101–8.

National Committee for Clinical Laboratory Standards. Performance standards for antimicrobial susceptibility testing; Twelfth informational supplement. Wayne: National Committee for Clinical Laboratory Standards, 2002: M100–S12.

Jacobson K, Rolston K, Elting L, LeBlanc B, Whimbey E, Ho DH. Susceptibility surveillance among gram-negative bacilli at a cancer center. Chemother 1999; 45 (5): 325–34.

Lopez A, Soler JA, Julia A, Novo A, Bueno J. Prophylaxis with ciprofloxacin in postchemotherapy neutropenia in acute myeloid leukaemia. Med Clin (Bar) 1994; 102 (3): 81–5.

Moriuchi Y, Kamihira S, Yamamura M, Mori H, Myazaki Y, Tokugana S. Comparison of ciprofloxacin with polymyxin B for infection prophylaxis in neutropenic patients with acute non-lymphocytyc leukemia. Rinsho Ketsueki 1990; 31 (10): 1664–9.

Patterson DL, Mulazimoglu L, Casellas JM, Ko WC, Gossens H, et al. Epidemiology of ciprofloxacin resistance and its relatioship to extended-spectrum beta-lactamase production in Klebsiella pneumoniae isolate causing bacteremia. Clin Infect Dis 2000; 30 (3): 473–8.

How to Cite
1.
Strauch R, Andlovic A, Černelč P. PERCENTAGE OF CIPROFLOXACIN-RESISTANT STRAINS OF CITROBACTER FREUNDII IN ACUTE LEUKAEMIA PATIENTS WITH CIPROFLOXACIN PROPHYLAXIS. ZdravVestn [Internet]. 1 [cited 22Sep.2019];73. Available from: https://vestnik.szd.si/index.php/ZdravVest/article/view/2455
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Professional Article