ABSTRACT
OBJECTIVES: Multidrug-resistant organisms (MDRO) are considered an emerging threat worldwide. Data covering the clinical impact of MDRO colonization in patients with solid malignancies, however, is widely missing. We sought to determine the impact of MDRO colonization in patients who have been diagnosed with Non-small cell lung cancer (NSCLC) who are at known high-risk for invasive infections. MATERIALS AND METHODS: Patients who were screened for MDRO colonization within a 90-day period after NSCLC diagnosis of all stages were included in this single-center retrospective study. RESULTS: Two hundred and ninety-five patients were included of whom 24 patients (8.1%) were screened positive for MDRO colonization (MDROpos) at first diagnosis. Enterobacterales were by far the most frequent MDRO detected with a proportion of 79.2% (19/24). MDRO colonization was present across all disease stages and more present in patients with concomitant diabetes mellitus. Median overall survival was significantly inferior in the MDROpos study group with a median OS of 7.8 months (95% CI, 0.0-19.9 months) compared to a median OS of 23.9 months (95% CI, 17.6-30.1 months) in the MDROneg group in univariate (p = 0.036) and multivariate analysis (P = 0.02). Exploratory analyses suggest a higher rate of non-cancer-related-mortality in MDROpos patients compared to MDROneg patients (p = 0.002) with an increased rate of fatal infections in MDROpos patients (p = 0.0002). CONCLUSIONS: MDRO colonization is an independent risk factor for inferior OS in patients diagnosed with NSCLC due to a higher rate of fatal infections. Empirical antibiotic treatment approaches should cover formerly detected MDR commensals in cases of (suspected) invasive infections.
Subject(s)
Bacteria/isolation & purification , Carcinoma, Non-Small-Cell Lung/microbiology , Drug Resistance, Multiple, Bacterial , Lung Neoplasms/microbiology , Adult , Aged , Aged, 80 and over , Bacteria/drug effects , Bacterial Infections/complications , Bacterial Infections/drug therapy , Bacterial Infections/mortality , Carcinoma, Non-Small-Cell Lung/complications , Carcinoma, Non-Small-Cell Lung/mortality , Carcinoma, Non-Small-Cell Lung/therapy , Cause of Death , Comorbidity , Female , Humans , Length of Stay/statistics & numerical data , Lung Neoplasms/complications , Lung Neoplasms/mortality , Lung Neoplasms/therapy , Male , Middle Aged , Nose/microbiology , Patient Admission/statistics & numerical data , Pharynx/microbiology , Rectum/microbiology , Retrospective Studies , Risk FactorsABSTRACT
Bradycardic arrhythmias have a broad spectrum of symptoms which range from mild dizziness to cardiac syncope. Pacemaker therapy continues to be the cornerstone of treatment and can effectively treat symptoms. Despite an implanted cardiac pacemaker, patients may experience continued or even new symptoms. We report on a 73-year-old woman with postoperative new palpitations due to a very rare intraoperative complication.
