Evaluating the Effects of Colonization with Multidrug-Resistant Bacteria on the Outcomes of Induction Chemotherapy in Patients with Acute Leukemia: A Prospective Analysis

Abstract

Introduction The presence of multi-drug resistant (MDR) bacteria has been linked to higher rates of morbidity and mortality in patients with acute leukemia.

Objective This prospective study aimed to evaluate the prevalence of MDR bacteria in stool samples of patients undergoing induction chemotherapy for acute leukemia and to explore its association with clinical outcomes.

Materials and Methods The study recruited 200 patients, aged 1-60 years, with newly diagnosed acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML) who were scheduled to receive intensive induction chemotherapy. Stool samples were obtained on days 1 and 15 of the induction phase, and standard bacterial culture methods were used to determine culture and sensitivity.

Results Two hundred patients were enrolled from January 2018 to March 2020. On day 1, 35.7% of the stool cultures were positive, with all identified bacteria being MDR. On day 15, 36.7% of the samples were positive for MDR bacteria. MDR E. coli and MDR Enterococcus faecium were the most common organisms isolated in the stool culture. The detection of MDR bacteria in day 15 stool cultures was significantly associated with an increased risk of infections, admissions to the intensive care unit, mortality, and failure to achieve remission.

Conclusion These findings indicate that monitoring stool colonization with MDR bacteria during induction chemotherapy could be crucial for identifying patients at elevated risk of adverse outcomes and optimizing antimicrobial strategies.

Keywords

infection - acute leukemia - multidrug resistant - chemotherapy - stool culture

• References

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