BACKGROUND: Bloodstream infections (BSI) are frequently observed after allogeneic hematopoietic stem cell transplant (HSCT), and could cause morbidity and mortality. METHODS: We retrospectively evaluated the incidence, characteristics of, and risk factors for BSI at both pre- and post-engraftment in 209 adult HSCT patients at our institute between June 2006 and December 2013. The median age at transplantation was 45 years (range, 15-65). A total of 122 patients received bone marrow, 68 received peripheral blood stem cells, and 19 received umbilical cord blood. RESULTS: The cumulative incidences of pre- and post-engraftment BSI were 38.9% and 17.2%, respectively. Nine patients had both pre- and post-engraftment BSI. In the pre- and post-engraftment periods, respectively, 67.4% and 84.1% of isolates were gram-positive bacteria (GPB), 28.3% and 11.4% were gram-negative bacteria (GNB), and 4.3% and 4.5% were fungi. Coagulase-negative staphylococci were the most commonly isolated GPB, while Stenotrophomonas maltophilia and Pseudomonas aeruginosa were the most commonly isolated GNB. Pre-engraftment BSI was associated with an increased risk of death. Overall survival at day 180 for patients with or without pre-engraftment BSI was 70.0% and 82.7%, respectively (P = 0.02). CONCLUSIONS: Risk factors for BSI in the pre-engraftment period were the interval between diagnosis and transplantation (261 days or more), engraftment failure, and high-risk disease status at HSCT in a multivariate analysis. No significant risk factor for BSI in the post-engraftment period was identified by a univariate analysis. These findings may be useful for deciding upon empiric antibacterial treatment for HSCT recipients.
BACKGROUND: Bloodstream infections (BSI) are frequently observed after allogeneic hematopoietic stem cell transplant (HSCT), and could cause morbidity and mortality. METHODS: We retrospectively evaluated the incidence, characteristics of, and risk factors for BSI at both pre- and post-engraftment in 209 adult HSCT patients at our institute between June 2006 and December 2013. The median age at transplantation was 45 years (range, 15-65). A total of 122 patients received bone marrow, 68 received peripheral blood stem cells, and 19 received umbilical cord blood. RESULTS: The cumulative incidences of pre- and post-engraftment BSI were 38.9% and 17.2%, respectively. Nine patients had both pre- and post-engraftment BSI. In the pre- and post-engraftment periods, respectively, 67.4% and 84.1% of isolates were gram-positive bacteria (GPB), 28.3% and 11.4% were gram-negative bacteria (GNB), and 4.3% and 4.5% were fungi. Coagulase-negative staphylococci were the most commonly isolated GPB, while Stenotrophomonas maltophilia and Pseudomonas aeruginosa were the most commonly isolated GNB. Pre-engraftment BSI was associated with an increased risk of death. Overall survival at day 180 for patients with or without pre-engraftment BSI was 70.0% and 82.7%, respectively (P = 0.02). CONCLUSIONS: Risk factors for BSI in the pre-engraftment period were the interval between diagnosis and transplantation (261 days or more), engraftment failure, and high-risk disease status at HSCT in a multivariate analysis. No significant risk factor for BSI in the post-engraftment period was identified by a univariate analysis. These findings may be useful for deciding upon empiric antibacterial treatment for HSCT recipients.
Authors: Joyce Ji; Jeff Klaus; Jason P Burnham; Andrew Michelson; Colleen A McEvoy; Marin H Kollef; Patrick G Lyons Journal: Chest Date: 2020-06-17 Impact factor: 9.410
Authors: Matthew Ziegler; Daniel Landsburg; David Pegues; Warren Bilker; Cheryl Gilmar; Colleen Kucharczuk; Theresa Gorman; Kristen Bink; Amy Moore; Rebecca Fitzpatrick; Edward A Stadtmauer; Patricia Mangan; Kelly Kraus; Jennifer H Han Journal: Biol Blood Marrow Transplant Date: 2018-11-24 Impact factor: 5.742
Authors: Karen Ballen; Kwang Woo Ahn; Min Chen; Hisham Abdel-Azim; Ibrahim Ahmed; Mahmoud Aljurf; Joseph Antin; Ami S Bhatt; Michael Boeckh; George Chen; Christopher Dandoy; Biju George; Mary J Laughlin; Hillard M Lazarus; Margaret L MacMillan; David A Margolis; David I Marks; Maxim Norkin; Joseph Rosenthal; Ayman Saad; Bipin Savani; Harry C Schouten; Jan Storek; Paul Szabolcs; Celalettin Ustun; Michael R Verneris; Edmund K Waller; Daniel J Weisdorf; Kirsten M Williams; John R Wingard; Baldeep Wirk; Tom Wolfs; Jo-Anne H Young; Jeffrey Auletta; Krishna V Komanduri; Caroline Lindemans; Marcie L Riches Journal: Biol Blood Marrow Transplant Date: 2016-06-22 Impact factor: 5.742