@article{Stoma_Karpov_Iskrov_Krivenko_Uss_Vlasenkova_Lendina_Cherniak_Suvorov_2018, title={DECOLONIZATION OF INTESTINAL CARRIAGE OF MDR/XDR GRAM-NEGATIVE BACTERIA WITH ORAL COLISTIN IN PATIENTS WITH HEMATOLOGICAL MALIGNANCIES: RESULTS OF A RANDOMIZED CONTROLLED TRIAL}, volume={10}, url={https://www.mjhid.org/mjhid/article/view/2018.030}, DOI={10.4084/mjhid.2018.030}, abstractNote={<p><strong>Background</strong></p><p>Intestinal colonization by MDR/XDR gram-negative bacteria leads to an increased risk of subsequent bloodstream infections (BSI) in patients receiving chemotherapy as a treatment for hematologic malignancies.</p><p><strong>Objectives</strong></p><p>The objective of this study was to evaluate the efficacy of oral colistin in eradicating the intestinal carriage of MDR/XDR Gram-negative bacteria in patients with hematological malignancies.</p><p><strong>Methods</strong></p><p>In a tertiary hematology center adult patients with intestinal colonization by MDR/XDR Gram-negative bacteria were included in a randomized controlled trial (RCT) during a period from November 2016 to October 2017. Patients were treated with oral colistin for 14 days or observed with the primary outcome set as a decolonization on day 21 post-treatment. Secondary outcomes included treatment safety and changes in MICs of isolated microorganisms. ClinicalTrials.gov Identifier: NCT02966457.</p><p><strong>Results</strong></p><p>Short-time positive effect (61.3% vs 32.3%; OR 3.32; 95% CI 1.17–9.44; p=0.0241) was demonstrated on the day 14 of colistin treatment, without any statistical difference on day 21 post-treatment. The incidence of BSI in decolonization group was lower in the first 30 days after the intervention (3.2% vs 12.9%), but overall in the 90-day observation period it did not show any advantages comparing to control group (log-rank test; p=0.4721). No serious adverse effects or increase in resistance to colistin was observed.</p><p><strong>Conclusions</strong></p><p>This study suggests that in hematological patients the strategy of selective intestinal decolonization by colistin may be beneficial to decrease the rate of MDR/XDR Gram-negative intestinal colonization and the risk of BSI in the short-term period, having no long-term sustainable effects.</p>}, number={1}, journal={Mediterranean Journal of Hematology and Infectious Diseases}, author={Stoma, Igor and Karpov, Igor and Iskrov, Igor and Krivenko, Svetlana and Uss, Anatoly and Vlasenkova, Svetlana and Lendina, Irina and Cherniak, Veronika and Suvorov, Dmitrii}, year={2018}, month={May}, pages={e2018030} }