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Colonization with multidrug-resistant organisms impairs survival in patients with hepatocellular carcinoma

Vera Himmelsbach1, Mate Knabe1, Phillip G Ferstl1

  • 1Department of Medicine, Gastroenterology, Hepatology and Endocrinology, Goethe University Frankfurt, Frankfurt/Main, Germany.

Journal of Cancer Research and Clinical Oncology
|July 20, 2021
PubMed
Abstract

Insights

Multidrug-resistant organism (MDRO) colonization significantly worsens survival in hepatocellular carcinoma (HCC) patients. Early screening and intervention are crucial for managing MDRO-colonized HCC patients.

Area of Science:

  • Oncology
  • Infectious Diseases
  • Hepatology

Background:

  • MDRO colonization is linked to poorer outcomes in various cancers and liver diseases.
  • The impact of MDRO colonization on hepatocellular carcinoma (HCC) patient prognosis remains understudied.
  • This study investigates the association between MDRO colonization and overall survival in HCC patients.

Purpose of the Study:

  • To determine the prognostic impact of multidrug-resistant organism (MDRO) colonization on overall survival in patients with hepatocellular carcinoma (HCC).
  • To identify MDRO colonization as a potential risk factor in HCC patient outcomes.

Main Methods:

  • Retrospective study of HCC patients diagnosed between January 2008 and December 2017.
  • Patients were categorized as MDRO-colonized (positive screening within 90 days of diagnosis) or non-colonized (negative screening).
  • Survival analysis was performed using multivariate analysis.

Main Results:

  • 6% of HCC patients were colonized with MDROs; Enterobacterales (ESBL/±FQ) and VRE were most common.
  • Colonized HCC patients presented with more severe cirrhosis and advanced tumor stage.
  • MDRO colonization was associated with significantly impaired overall survival (189 days vs. 1001 days) and identified as an independent risk factor.

Conclusions:

  • MDRO colonization is an independent negative prognostic factor for survival in HCC patients.
  • Highlights the critical need for routine MDRO screening and isolation protocols in HCC care.
  • Emphasizes the importance of interdisciplinary antibiotic stewardship for responsible antibiotic use.
Keywords:
Antibiotic steward-shipAntibioticsESBLHepatocellular carcinomaInfectionLiver cancerMultidrug-resistant organismsSurvivalVRE

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