Extended-spectrum beta-lactamase-producing Enterobacteriaceae related urinary tract infection in adult cancer patients: a multicenter retrospective study, 2015-2019.

BACKGROUND: The aim of this study was to investigate the prevalence and risk factors of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae related urinary tract infections (UTI) in adult cancer patients. METHODS: We conducted a retrospective study of three cancer hospitals centered on Cancer Hospital of Chinese Academy of Medical Sciences from 2015 to 2019. The clinical characters, risk factors and antimicrobial susceptibility of ESBL-producing Enterobacteriaceae UTI in adult cancer patients were described and analyzed. RESULTS: A total of 4967 specimens of UTI were evaluated, of which 909 were positive. After excluding multiple infection bacteria, non-conforming strains, inconsistent pathological information, no drug sensitivity test or medical records, 358 episodes remained. Among them, 160 episodes belonged to ESBL-producing Enterobacteriaceae, while 198 were classified into non-ESBL group. The prevalence of ESBL UTI circled around 39.73 to 53.03% for 5 years. Subgroup analysis by tumor type revealed that 62.5% of isolates from patients with urological tumors were ESBL positive. Multivariate analysis showed that tumor metastasis (OR 3.41, 95%CI 1.84-6.30), urological cancer (OR 2.96, 95%CI 1.34-6.53), indwelling catheter (OR 2.08, 95%CI 1.22-3.55) and surgery or invasive manipulation (OR 1.98, 95%CI 1.13-3.50) were the independent risk factors. According to antimicrobial sensitivity, meropenem, imipenem and piperacillin/tazobactam were the most commonly used antibiotics for ESBL-producing Enterobacteriaceae UTI. CONCLUSIONS: In view of the high prevalence, clinicians should be alert to the occurrence of ESBL UTI, especially for patients with urological cancer or metastatic tumors. Regular replacement of urinary catheters, reduction of unnecessary invasive operations and selection of appropriate antibiotics are the necessary conditions to deal with the occurrence of ESBL UTI in adult cancer patients.

[Short-term efficacy comparison of laparoscopic-assisted versus open distal gastrectomy].

OBJECTIVE: To compare the short-term efficacy of laparoscopic-assisted verus open distal gastrectomy for gastric cancer. METHODS: The data of 29 patients with distal gastric cancer from January 2008 to October 2010 were analyzed. RESULTS: Twenty-eight underwent laparoscopic-assisted distal gastrectomy while 1 was switched to open surgery. The operative duration was (253.1 ± 32.6) min and the blood loss volume (268.5 ± 101.4) ml. The postoperative recovery time of gastrointestinal peristalsis was (2.1 ± 0.6) d. The length of incision was (5.6 ± 1.6) cm, the hospital stay duration (10.6 ± 2.4) d and the number of dissected lymph nodes (34.5 ± 5.2). CONCLUSION: Laparoscopic-assisted distal gastrectomy for gastric cancer is both safe and feasible. And it offers many advantages of minimal invasion, less pain and shorter hospital stay.