Neuroinvasive Bacillus cereus Infection in Immunocompromised Hosts: Epidemiologic Investigation of 5 Patients With Acute Myeloid Leukemia.

Autor: Little JS; Harvard Medical School, Boston, Massachusetts, USA.; Dana-Farber Cancer Institute, Boston, Massachusetts, USA.; Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA., Coughlin C; Harvard Medical School, Boston, Massachusetts, USA.; Dana-Farber Cancer Institute, Boston, Massachusetts, USA.; Department of Infection Control, Brigham and Women's Hospital, Boston, Massachusetts, USA., Hsieh C; Harvard Medical School, Boston, Massachusetts, USA.; Dana-Farber Cancer Institute, Boston, Massachusetts, USA.; Department of Infection Control, Brigham and Women's Hospital, Boston, Massachusetts, USA., Lanza M; Harvard Medical School, Boston, Massachusetts, USA.; Dana-Farber Cancer Institute, Boston, Massachusetts, USA.; Department of Infection Control, Brigham and Women's Hospital, Boston, Massachusetts, USA., Huang WY; Harvard Medical School, Boston, Massachusetts, USA.; Dana-Farber Cancer Institute, Boston, Massachusetts, USA.; Department of Infection Control, Brigham and Women's Hospital, Boston, Massachusetts, USA., Kumar A; Harvard Medical School, Boston, Massachusetts, USA.; Dana-Farber Cancer Institute, Boston, Massachusetts, USA.; Department of Infection Control, Brigham and Women's Hospital, Boston, Massachusetts, USA., Dandawate T; Dana-Farber Cancer Institute, Boston, Massachusetts, USA.; Department of Infection Control, Brigham and Women's Hospital, Boston, Massachusetts, USA., Tucker R; Harvard Medical School, Boston, Massachusetts, USA.; Department of Infection Control, Brigham and Women's Hospital, Boston, Massachusetts, USA., Gable P; Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Vazquez Deida AA; Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Moulton-Meissner H; Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Stevens V; Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., McAllister G; Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Ewing T; Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Diaz M; Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Glowicz J; Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Winkler ML; Harvard Medical School, Boston, Massachusetts, USA.; Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Division of Microbiology, Brigham and Women's Hospital, Boston, Massachusetts, USA., Pecora N; Harvard Medical School, Boston, Massachusetts, USA.; Division of Microbiology, Brigham and Women's Hospital, Boston, Massachusetts, USA., Kubiak DW; Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Department of Pharmacy, Brigham and Women's Hospital, Boston, Massachusetts, USA., Pearson JC; Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Department of Pharmacy, Brigham and Women's Hospital, Boston, Massachusetts, USA., Luskin MR; Harvard Medical School, Boston, Massachusetts, USA.; Dana-Farber Cancer Institute, Boston, Massachusetts, USA., Sherman AC; Harvard Medical School, Boston, Massachusetts, USA.; Dana-Farber Cancer Institute, Boston, Massachusetts, USA.; Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA., Woolley AE; Harvard Medical School, Boston, Massachusetts, USA.; Dana-Farber Cancer Institute, Boston, Massachusetts, USA.; Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA., Brandeburg C; Massachusetts Department of Public Health, Boston, Massachusetts, USA., Bolstorff B; Massachusetts Department of Public Health, Boston, Massachusetts, USA., McHale E; Massachusetts Department of Public Health, Boston, Massachusetts, USA., Fortes E; Massachusetts Department of Public Health, Boston, Massachusetts, USA., Doucette M; Massachusetts Department of Public Health, Boston, Massachusetts, USA., Smole S; Massachusetts Department of Public Health, Boston, Massachusetts, USA., Bunnell C; Harvard Medical School, Boston, Massachusetts, USA.; Dana-Farber Cancer Institute, Boston, Massachusetts, USA., Gross A; Harvard Medical School, Boston, Massachusetts, USA.; Dana-Farber Cancer Institute, Boston, Massachusetts, USA., Platt D; Harvard Medical School, Boston, Massachusetts, USA.; Dana-Farber Cancer Institute, Boston, Massachusetts, USA., Desai S; Harvard Medical School, Boston, Massachusetts, USA.; Department of Quality and Safety, Brigham and Women's Hospital, Boston, Massachusetts, USA., Fiumara K; Harvard Medical School, Boston, Massachusetts, USA.; Department of Infection Control, Brigham and Women's Hospital, Boston, Massachusetts, USA., Issa NC; Harvard Medical School, Boston, Massachusetts, USA.; Dana-Farber Cancer Institute, Boston, Massachusetts, USA.; Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA., Baden LR; Harvard Medical School, Boston, Massachusetts, USA.; Dana-Farber Cancer Institute, Boston, Massachusetts, USA.; Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA., Rhee C; Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Department of Infection Control, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Healthcare Institute, Boston, Massachusetts, USA., Klompas M; Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Department of Infection Control, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Healthcare Institute, Boston, Massachusetts, USA., Baker MA; Dana-Farber Cancer Institute, Boston, Massachusetts, USA.; Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Department of Infection Control, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Healthcare Institute, Boston, Massachusetts, USA.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2024 Jan 25; Vol. 11 (3), pp. ofae048. Date of Electronic Publication: 2024 Jan 25 (Print Publication: 2024).
DOI: 10.1093/ofid/ofae048
Abstrakt: Background: Bacillus cereus is a ubiquitous gram-positive rod-shaped bacterium that can cause sepsis and neuroinvasive disease in patients with acute leukemia or neutropenia.
Methods: A single-center retrospective review was conducted to evaluate patients with acute leukemia, positive blood or cerebrospinal fluid test results for B cereus , and abnormal neuroradiographic findings between January 2018 and October 2022. Infection control practices were observed, environmental samples obtained, a dietary case-control study completed, and whole genome sequencing performed on environmental and clinical Bacillus isolates.
Results: Five patients with B cereus neuroinvasive disease were identified. All patients had acute myeloid leukemia (AML), were receiving induction chemotherapy, and were neutropenic. Neurologic involvement included subarachnoid or intraparenchymal hemorrhage or brain abscess. All patients were treated with ciprofloxacin and survived with limited or no neurologic sequelae. B cereus was identified in 7 of 61 environmental samples and 1 of 19 dietary protein samples-these were unrelated to clinical isolates via sequencing. No point source was identified. Ciprofloxacin was added to the empiric antimicrobial regimen for patients with AML and prolonged or recurrent neutropenic fevers; no new cases were identified in the ensuing year.
Conclusions: B cereus is ubiquitous in the hospital environment, at times leading to clusters with unrelated isolates. Fastidious infection control practices addressing a range of possible exposures are warranted, but their efficacy is unknown and they may not be sufficient to prevent all infections. Thus, including B cereus coverage in empiric regimens for patients with AML and persistent neutropenic fever may limit the morbidity of this pathogen.
Competing Interests: Potential conflicts of interest. M. K.: royalties from UpToDate. All other authors report no potential conflicts.
(© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje