Clinical Analysis of Bloodstream Infection of Escherichia coli in Patients with Pancreatic Cancer from 2011 to 2019.

Background: Pancreatic cancer patients were particularly predisposed to develop Escherichia coli (E. coli) bloodstream infection (BSI); however, little information is currently available. We set out to find E. coli BSI's risk factors in pancreatic cancer to provide valuable experience. Methods: We retrospectively analyzed the clinical data of pancreatic cancer patients (31 cases with E. coli BSI and 93 cases without BSI) by a case-control study. SPSS 17.0 was adopted to perform univariate and multivariate analyses. Bacterial resistance analysis was performed by Whonet 5.6. Results: Hospitalization days ≥7 days, number of admissions ≥2 times, surgery, chemotherapy, the type of antibiotics used ≥2 species, albumin<40.0 g/L, and prealbumin < 0.2 g/L were the potential risk factors for pancreatic cancer patients with E. coli BSI (P < 0.1). Multivariate logistic regression showed hospitalization days ≥7 days (OR = 11.196, 95% CI = 0.024-0.333, P < 0.001), surgery (OR = 32.053, 95% CI = 0.007-0.137, P < 0.001), and chemotherapy (OR = 6.174, 95% CI = 0.038-0.688, P=0.014) were the independent risk factors for E. coli BSI of pancreatic cancer patients. E. coli resistant to carbapenems was rare; they were susceptible to cephamycin and piperacillin/tazobactam. The 90-day mortality rate of the infected group was significantly higher than the control group (41.9% versus 8.6%, P < 0.001). Conclusions: Hospitalization days ≥7 days, surgery, and chemotherapy are the independent risk factors for E. coli BSI of pancreatic cancer patients, which allows us to identify patients at potential risk and perform preventive treatment in time.

Residents had an increasing risk of norovirus gastroenteritis infection than health care workers during an outbreak in a nursing home.

OBJECTIVES: To study norovirus gastroenteritis infection among residents and health care workers (HCWs) during an outbreak in a nursing home by investigating the attack rate and positive diagnostic rate for norovirus by reverse transcription-polymerase chain reaction (RT-PCR). METHODS: All members in a Chang Gung Memorial Hospital-affiliated nursing home from November 17, 2006, to November 25, 2006, including 236 residents and 125 HCWs, whose available medical records were available were consecutively included in the retrospective analysis. Fecal specimens of symptomatic residents and HCWs were tested for norovirus by RT-PCR. In addition, routine stool analysis and a stool culture study were conducted to identify the bacterial and parasitic agents. The fecal specimens of asymptomatic residents and HCWs were tested only for norovirus by RT-PCR. RESULTS: The outbreak was controlled within 9 days during the outbreak period. There were 51 symptomatic cases, 41 residents and 10 HCWs, during the norovirus outbreak. The odds ratio (OR) of the attack rate in the residents was approximately 2.4 times higher than that in the HCWs (OR: 2.4; 95% confidence interval [CI]: 1.2-5.0; P = .015). Norovirus was detected in 59 (30.6%) of 193 residents and in 11 (10.5%) of 105 HCWs who provided stool specimens for the study by RT-PCR. The OR of the positive diagnostic rate for norovirus by RT-PCR in the residents was approximately 3.8 times higher than that in the HCWs (OR: 3.8; 95% CI: 1.9-7.5; P < .001). CONCLUSIONS: During an outbreak of norovirus gastroenteritis in a nursing home, the infection can be easily transmitted from person to person and affects both residents and HCWs. In addition, residents had a higher risk of norovirus gastroenteritis infection than HCWs.