Prevalence of Extended-Spectrum Beta-Lactamase ProducingEscherichia coli Causing Bloodstream Infections in patients withleukemia undergoing levofloxacin prophylaxis

Background and Aim : Bloodstream infections (BSIs) are severe complications in patients withleukemia undergoing levofloxacin prophylaxis during chemotherapy. extended-spectrum betalactamase(ESBL) producing Escherichia coli are rising worldwide, resulting in increasedmorbidity, mortality, and healthcare costs, This study aimed to evaluate the frequency rate ofextended-spectrum beta-lactamase-producing Escherichia coli causing bloodstream infections(BSIs) in leukemia patients referred to referral hospitals in Tehran, Hamadan, and Rasht, Iran.Methods : in a cross-sectional study, ۶۴ blood cultures were collected from leukemia patientssuspected to have BSI from July ۲۰۲۱ to February ۲۰۲۲. The blood culture bottles were incubatedaerobically at ۳۵–۳۷ºC for ۲۴ hours and then sub-cultured on routine microbiology culture media.The bacterial colonies were identified using microbiological tests. Antibiotic susceptibility testswere performed by the Kirby-Bauer disc diffusion method. The phenotypic detection of ESBLswas carried out by the combination disc-diffusion test (CDDT).Results : according to the results of this study.The rate of resistance of ۶۴ E. coli isolates againstthe nine antibiotics was as follows: Amoxicillin-clavulanic acid ۹۵%, Ampicillin ۹۳%, Cefepime۵۷.۸%, cefixime ۵۷.۸%, Ceftazidime ۵۹.۳%, ceftriaxone ۶۴%, imipenem ۶.۲% ciprofloxacin ۵۶%,to levofloxacin ۵۴%. The production of extended-spectrum beta-lactamases (ESBL) in E. colistrains was reported in ۵۶.۲%Conclusion : The results of this study show a high prevalence of resistance to beta-lactam andfluoroquinolone antibiotics in patients with leukemia undergoing levofloxacin prophylaxis.Therefore, surveillance and antibiotic stewardship programs should be implemented in leukemiapatients to prevent spreading and outbreaks of more ESBLs with limited therapeutic choices.

کلیدواژه ها:

Leukemia ، Levofloxacin ، Extended spectrum beta-lactamase-producing ، Escherichiacoli