Current Issues of Pharmacy and Medical Sciences

Microbiological monitoring in patients with advanced ovarian cancer before and after cytoreductive surgery – a preliminary report

Curr Issues Pharm Med Sci., Vol. 30, No. 4, 198-202

Maria Szymankiewicz1, Krzysztof Koper2,5, Konrad Dziobek3,
Zbigniew Kojs3, Lukasz Wicherek4,5*

1 Department of Microbiology, Professor Franciszek Lukaszczyk Oncology Center, Bydgoszcz, Romanowskiej 2, 85-796 Bydgoszcz, Poland
2 Department of Oncology, Professor Franciszek Lukaszczyk Oncology Center, Bydgoszcz, Romanowskiej 2, 85-796 Bydgoszcz, Poland
3 Department of Gynecologic Oncology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology in Warsaw, Division in Krakow, Garncarska 11, 31-115 Krakow, Poland
4 Clinical Department of Gynecologic Oncology, Professor Franciszek Lukaszczyk Oncology Center, Bydgoszcz, Romanowskiej 2, 85-796 Bydgoszcz, Poland
5 Department of Oncology, Radiotherapy and Oncological Gynecology, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Romanowskiej 2, 85-796 Bydgoszcz, PolandDepartment of Virology, Medical University of Lublin, Chodzki 1, 20-093 Lublin, Poland

DOI: 10.1515/cipms-2017-0038

Abstract

Multidrug-resistant organisms (MDROs) are becoming an increasing problem in hospitals. It is believed that screening patients for the incidence of MDROs prior to hospital admission not only allows for the proper management of infection following medical procedures, but can also potentially reduce the transmission of these bacteria to other patients.
The aim of this study was to assess the carriers of selected MDROs in the gastrointestinal tract among patients with advanced ovarian cancer admitted to the hospital for cytoreductive surgery and to estimate the possible relationship between rectal colonization with these organisms and nosocomial infections.
From December 2013 to May 2014, we evaluated the colonization with VRE (vancomycin- resistant Enterococcus), E. coli KPC+ (class A carbapenemase producing Escherichia coli), E. coli MBL+ (class B carbapenemase, metallo-ß lactamase producing Escherichia coli), and E. coli ESBL+ (extended-spectrum ß-lactamase producing Escherichia coli) in 42 patients. The patients were divided into two subgroups corresponding to the extent of their surgery: the first subgroup consisted of patients with large bowel resection (n=18) and the second subgroup of patients without resection (n=24). A rectal swab was taken within 24 hours of admission. Perioperative infectious complications were analyzed for the first 90 days following surgery with regard to the type of infection and the occurrence of examined MDROs.
In our study, 2.4 % of all patients (23.8/1,000 hospitalizations) were colonized with ESBL - producing Escherichia coli: 0.0 % in the first subgroup and 4.2% in the second subgroup, respectively. We did not identify any patients who were colonized with VRE, E. coli MBL+, or E. coli KPC+. Surgical site infections were seen in 8 (19.1%) out of 42 patients. We were, therefore, unable to confirm a relationship between MDROs colonizing the large bowel and the etiological agents of perioperative infections. However, despite the lack of identification of MDROs as etiological agents of postoperative infection, the risk of serious infectious complications, combined with the changing epidemiological situation, means that microbiological monitoring should be performed in patients with ovarian cancer before and after cytoreductive surgery.

Keywords

microbiological monitoring, multidrug-resistant organisms, advanced ovarian cancer, cytoreductive surgery

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