| Title |
Incomplete recovery of the fecal flora of hematological patients with neutropenia and repeated fluoroquinolone prophylaxis
|
|---|---|
| Published in |
Infection and Drug Resistance, June 2017
|
| DOI | 10.2147/idr.s133333 |
| Pubmed ID | |
| Authors |
Yong Chong, Shinji Shimoda, Noriko Miyake, Takatoshi Aoki, Yoshikiyo Ito, Tomohiko Kamimura, Nobuyuki Shimono |
| Abstract |
Routine fluoroquinolone prophylaxis in neutropenic patients with hematological malignancies is still controversial, because of antibiotic resistance concerns. The recovery of the fecal microbiota to the initial composition in patients receiving multiple courses of quinolone prophylaxis and repeated chemotherapy has not been evaluated. We prospectively examined the changes in the fecal bacterial composition before and after levofloxacin prophylaxis. A sequential observation of bacterial resistance in patients receiving multiple prophylactic courses was also conducted. In this trial, 68 cases, including (35 with the first course and 33 with the second and subsequent courses) were registered. The disappearance of quinolone-susceptible (QS) Entero-bacteriaceae and dominant emergence of quinolone-resistant (QR) coagulase negative staphylococci (CNS) and QR Enterococci were observed after the first prophylaxis. The detection of QS Enterobacteriaceae was recovered before the second and subsequent courses to a level of the initial composition (28/35 samples, 80.0% before the first course vs 23/33 samples, 69.7% before the second and subsequent courses, P=0.41). In contrast, the detection rate of QR CNS and Enterococci significantly increased at the second and subsequent courses, even before prophylaxis (8/35 samples, 22.9% before the first course vs 20/33 samples, 60.6% before the second and subsequent courses, P=0.003). The incomplete recovery of the initial bacterial composition was associated with a prophylactic interval of within 30 days. Of the patients receiving multiple prophylactic courses, six had QR Escherichia coli, including extended-spectrum β-lactamase (ESBL) producers, at the first course, and four (66.3%) of the six patients had persistent detection of QR E. coli at the second course. In patients receiving multiple courses of prophylactic quinolone, along with a common chemotherapy schedule, newly emergent resistant bacteria could be frequently persistent in their fecal flora. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 3 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 3 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 23 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 23 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 4 | 17% |
| Student > Bachelor | 3 | 13% |
| Student > Ph. D. Student | 2 | 9% |
| Researcher | 2 | 9% |
| Student > Master | 2 | 9% |
| Other | 2 | 9% |
| Unknown | 8 | 35% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 6 | 26% |
| Pharmacology, Toxicology and Pharmaceutical Science | 3 | 13% |
| Immunology and Microbiology | 3 | 13% |
| Biochemistry, Genetics and Molecular Biology | 1 | 4% |
| Unknown | 10 | 43% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 21 July 2017.
All research outputs
#15,466,074
of 22,982,639 outputs
Outputs from Infection and Drug Resistance
#729
of 1,676 outputs
Outputs of similar age
#198,878
of 316,544 outputs
Outputs of similar age from Infection and Drug Resistance
#7
of 8 outputs
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