Bloodstream Infections and Outcomes Following Allogeneic Hematopoietic Cell Transplantation: A Single-Center Study

Carreira, Abel Santos; Salas, María Queralt; Remberger, Mats; Basso, Igor Novitzky; Law, Arjun; Lam, Wilson; Pašić, Ivan; Kim, Dennis; Michelis, Fotios V.; Viswabandya, Auro; Gerbitz, Armin; Lipton, Jeffrey H.; Husain, Shahid; Kumar, Rajat; Mattsson, Jonas

doi:10.1016/j.jtct.2021.10.008

Cited by 23 publications

(15 citation statements)

References 35 publications

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“…Timedependent neutrophil recovery in our study on the other hand contributed to a lower BSI incidence (HR 0.44; 95%CI 0.26 -0.73). Acute GvHD, disease progression/relapse, preexisting comorbidities and male gender were independent risk factors for BSI, which confirms findings from other studies (1,2,17,19).…”

Section: Discussionsupporting

confidence: 89%

“…However, the The predominance of E. coli, P. aeruginosa and Klebsiella spp. corresponds to published data from Israel, North America, and Europe (2,6,20,22). Only few systematic data report on resistance in HCT recipients.…”

Section: Discussionmentioning

confidence: 66%

“…Bloodstream infection (BSI) is the most common infectious complication after allogeneic haematopoietic cell transplantation (HCT) affecting 20 to 60% of patients in the pre-and early post-engraftment phase (1)(2)(3)(4). Beyond engraftment, particularly patients with acute graftversus-host disease (aGvHD) and ongoing immunosuppressive treatment, remain at risk for BSI (5).…”

Section: Introductionmentioning

confidence: 99%

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Bloodstream infections in allogeneic haematopoietic cell recipients from the Swiss Transplant Cohort Study

Weisser

Sava

Baettig³

et al. 2022

Preprint

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Empiric antibiotic treatment for bloodstream infection (BSI) after haematopoietic cell transplantation (HCT) in the era of antimicrobial resistance is challenging. We conducted a nested project in the Swiss Transplant Cohort Study 09/2009 to 10/2018 assessing BSI incidence, pathogen distribution and antimicrobial resistance. Cox proportional hazards models were fitted to detect factors associated with BSI and outcome. We included 1 364 adults (61.1% male) receiving 1 432 HCTs complicated by 676 BSIs in 451 (33%) patients. Cumulative incidence of BSI was 20.5% (95%CI 18.4 – 22.7) until day 100 after the first HCT. Gram-positive pathogens, mostly coagulase-negative staphylococci, dominated (454, 58.1%). Production of extended-spectrum beta-lactamases and quinolone-resistance were observed in 41/195 (21%) and 81/195 (41.5%) of Enterobacterales, respectively. Carbapenem-resistance was documented in 10/49 (20.4%) of Pseudomonas aeruginosa isolates. Multivariable cox regression analysis within the first-year post-transplant identified male gender, comorbidities, myeloablative regimen, acute graft-versus-host disease grade III/IV and haematological progression/relapse after HCT as independent risk factors for BSI. One-year mortality was 26.6% with BSI modeled as a time-dependent covariable independent risk factor for mortality. To conclude, BSI remains a frequent complication after HCT, with stable rates of antibiotic resistance in BSI-causing pathogens in Switzerland. BSI was a major contributor to mortality.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%

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Bloodstream infections in allogeneic haematopoietic cell recipients from the Swiss Transplant Cohort Study

Weisser

Sava

Baettig³

et al. 2022

Preprint

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“…The highest BSI incidence was in the peri-transplantation phase of the second transplant (30.6%; 95% CI 19.9–41.9). This high BSI rate of about one-third of our patients occurring mostly within the first 30 days after HCT has been reported from other centers (12–55%) [ 8 , 9 ], also those using quinolone prophylaxis [ 1 – 3 ].…”

Section: To the Editorsupporting

confidence: 79%

“…Bloodstream infection (BSI) is the most common infectious complication after allogeneic haematopoietic cell transplantation (HCT) affecting 20–60% of patients in the pre- and early post-engraftment phase [ 1 – 3 ] and later in patients acute graft-versus-host disease (aGvHD) [ 4 ]. While quinolone prophylaxis during aplasia is beneficial to some extent, breakthrough BSIs caused by multidrug-resistant (MDR) bacteria have been reported [ 2 , 5 ].…”

Section: To the Editormentioning

confidence: 99%

Bloodstream infections in allogeneic haematopoietic cell recipients from the Swiss Transplant Cohort Study: trends of causative pathogens and resistance rates

Sava

Bättig

Gerull

et al. 2022

Bone Marrow Transplant

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Interventional antibiotic treatment replacing antibiotic prophylaxis during allogeneic hematopoietic stem cell transplantation is safe and leads to a reduction of antibiotic administration

Toenges,

Lang,

Ghaffar

et al. 2024

Ann Hematol

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Bloodstream Infections and Outcomes Following Allogeneic Hematopoietic Cell Transplantation: A Single-Center Study

Cited by 23 publications

References 35 publications

Bloodstream infections in allogeneic haematopoietic cell recipients from the Swiss Transplant Cohort Study

Bloodstream infections in allogeneic haematopoietic cell recipients from the Swiss Transplant Cohort Study

Bloodstream infections in allogeneic haematopoietic cell recipients from the Swiss Transplant Cohort Study: trends of causative pathogens and resistance rates

Interventional antibiotic treatment replacing antibiotic prophylaxis during allogeneic hematopoietic stem cell transplantation is safe and leads to a reduction of antibiotic administration

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