A recent study was published online in March by the journal Clinical Infectious Diseases that the Centers for Disease Control and Prevention (CDC) calls the first nationwide evaluation of pathogen patterns and antimicrobial resistance trends among central line-associated bloodstream infections (CLABSI) from inpatient oncology settings in more than a decade.
The study is the brainchild of Alison Freifeld, M.D., professor of internal medicine-infectious diseases at UNMC — although she credits CDC research epidemiologist Isaac See, M.D., first author of the paper, with “90 percent” of the work.
Dr. Freifeld is the chair of the Infectious Diseases Society of America (IDSA) guidelines on managing infections in cancer, and she’s been thinking for a long time about how to get this information on a national and even global scale.
The paper describes CLABSI pathogens and antimicrobial resistance patterns reported from oncology locations to the CDC’s National Healthcare Safety Network (NHSN).
“My whole academic and professional life has focused on the causes of severe infection in cancer patients and how we can better anticipate, treat and prevent those infections which may be life-threatening or worse,” Dr. Freifeld said. “In addition, infections can often result in chemotherapy delays that may undermine the effectiveness of those treatments. So infections play a major interfering role in cancer care.
“Bloodstream bacterial infections are especially devastating in cancer patients. Although individual cancer centers or hospitals keep this information, there has been no collated nationwide data generated for bloodstream infections in cancer patients since the early 2000s. A lot has since changed in terms of emerging antibiotic resistance. My question was whether the antibiotics we now recommend to empirically treat cancer patients with possible bloodstream infections should remain the same, after 20 years of making the exact same recommendations? In order to answer that question, we needed the data to guide us.
“Knowing that CDC keeps data about bloodstream infections from hospitals across the country, I tracked down which people there would be interested in my idea,” she said. I was very pleased to find very smart, thoughtful, willing partners at the CDC.”
With Dr. See taking the lead — the concepts discussed in the paper and decisions about how to frame the analysis were largely his — and with input from Dr. Freifeld and Shelley Magill, M.D., Ph.D., at CDC, the paper was completed.
“With this nationwide data about the predominant bacteria causing CLABSI infections, and their antibiotic susceptibility patterns, we can begin to address the question of what are the best antibiotics to use in the cancer setting,” Dr. Freifeld said.
Congratulations on the research