Escalating Mortality Risk: Antimicrobial Resistance in Cancer Patients with Bacteremia

Strategic Insights -

A study published in the BMJ Open journal reveals the alarming rise of antimicrobial resistance (AMR) in cancer patients with bacteremia, resulting in increased mortality rates. Researchers from Mahidol University and Oxford University Hospitals analyzed data from 2008 to 2018, finding that the highest resistance proportions were for vancomycin-resistant enterococci and carbapenem-resistant Pseudomonas aeruginosa in Oxford, while Escherichia coli and Klebsiella pneumoniae showed high resistance rates in Oslo. The study estimated that 32 deaths out of 509 could be attributed to AMR, highlighting the potential for escalating mortality if global resistance trends continue to worsen.

Key Takeaways:

  • The study investigated the epidemiology and impact of antimicrobial resistance on mortality in cancer patients with bacteremia at Oxford University Hospitals and Oslo University Hospital over a 10-year period (2008-2018).
  • The research revealed that the highest resistance proportions were found for vancomycin resistance in enterococci (27.1%) and carbapenem-resistance in Pseudomonas aeruginosa (24.2%) at Oxford, and for third-generation cephalosporin resistance in Escherichia coli (8.3%) and Klebsiella pneumoniae (6.3%) at Oslo.
  • The study estimated a 6.3% population-attributable fraction (PAF) due to AMR, meaning an estimated 32 deaths out of 509 could be attributed to AMR.
  • The study's findings highlight the potential for escalating mortality if global resistance trends continue to worsen.
  • The research was supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Helse SoR-ost Rhf, and the National Institute for Health Research Health Protection Research Unit.
  • The study emphasizes the need for aggressive antimicrobial stewardship and research to combat the growing threat of antimicrobial resistance.

Statistics:

  • 1929 patients at Oxford University Hospitals and 1640 patients at Oslo University Hospital were included in the study.
  • The study found that the highest resistance proportions were for vancomycin-resistant enterococci (85/314, 27.1%) and carbapenem-resistant Pseudomonas aeruginosa (63/260, 24.2%) at Oxford.
  • The study estimated a 26.4% observed mortality rate for all infections at Oxford, with an estimated counterfactual mortality without AMR of 24.7%, resulting in an excess mortality of 1.7% (95% CI: 0.8 to 2.5%).
  • The study's findings suggest that 32 deaths out of 509 could be attributed to AMR.

Sources:

  • "Epidemiology and excess mortality of antimicrobial resistance in bacteraemias among cancer patients: a cohort study using routinely collected health data from regional hospital trusts in Oxford and Oslo, 2008-2018." BMJ Open, 2025,15(6). (BMJ Open - http://bmjopen.bmj.com/)
  • NewsRx. Mahidol University Researchers Release New Study Findings on Bacteremia (Epidemiology and excess mortality of antimicrobial resistance in bacteraemias among cancer patients: a cohort study using routinely collected health data from regional ...). Health & Medicine Week. July 4, 2025; p 2237.