Febrile Neutropenia in Transplant Recipients

Nesher, Lior; Rolston, Kenneth V. I.

doi:10.1007/978-1-4939-9034-4_9

Cited by 3 publications

(3 citation statements)

References 127 publications

(155 reference statements)

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“…Febrile neutropenia (FN) is a common complication following hematopoietic stem cell transplantation (HSCT) and is associated with poor outcomes. 1,2 The Infectious Diseases Society of America guidelines recommend obtaining daily sets of blood cultures on each of the first 3 days of persistent FN. 3 However, unnecessary repeat blood culture collection has been demonstrated to increase health care for individuals grappling with high-risk hematologic malignancies.…”

Section: Introductionmentioning

confidence: 99%

“…Consequently, nearly all patients who undergo HSCT experience neutropenia, with up to 80% developing FN during the early post-transplantation phase. 2 Despite the increased infectious risk in patients undergoing HSCT, prior studies have not specifically examined the utility of repeat blood cultures in this susceptible patient population. Thus, we sought to explore the utility of repeat blood cultures in bacteremic acute myeloid leukemia (AML) patients in the early post-transplant period.…”

Section: Introductionmentioning

confidence: 99%

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Yield of repeat blood cultures in acute myeloid leukemia patients with febrile neutropenia and bacteremia following allogeneic hematopoietic stem cell transplant

Sheu,

Molina Garcia,

Shrivastava

et al. 2024

Transplant Infectious Dis

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IntroductionThis study explored the efficacy of repeat blood cultures in bacteremic acute myeloid leukemia (AML) patients following allogeneic hematopoietic stem cell transplantation (HSCT).MethodsThis was a retrospective study of AML patients who experienced febrile neutropenia (FN) and bacteremia following HSCT at the Taussig Cancer Center from January 1, 2019, to December 31, 2022. The primary endpoint was the rate of positive repeat blood cultures following initial positive blood culture.ResultsFifty patients were included in the study. There were 50 occurrences of FN with positive initial blood cultures that were diagnosed following HSCT. Fifty initial sets of blood cultures and 96 sets of repeat blood cultures were drawn between the 50 occurrences of FN. Twelve of 96 (12.5%) repeat blood culture sets were positive for a pathogen, which occurred over nine of 50 (18.0%) episodes of FN. Three of 96 (3.2%) repeat blood culture sets grew a pathogen that differed from the pathogen that grew in the preceding positive blood culture.ConclusionAmong bacteremic AML patients in the post‐HSCT period, the yield of repeat blood cultures for detecting previously detected and new pathogens was low. image

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Yield of repeat blood cultures in acute myeloid leukemia patients with febrile neutropenia and bacteremia following allogeneic hematopoietic stem cell transplant

Sheu,

Molina Garcia,

Shrivastava

et al. 2024

Transplant Infectious Dis

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“…Hematopoietic cell transplantation is associated with increased risk of severe infection, in part, due to prolonged neutropenia after conditioning chemotherapy and/or radiation [ 2 ]. Although the incidence of febrile neutropenia (FN) after HCT is estimated to be as high as 80%, only 20%–25% of FN episodes result from microbiologically documented infections [ 3 ]. Identification of urinary tract infections (UTIs) during FN may be complicated by the potential absence of pyuria, and transplant centers take a variety of different approaches in evaluating HCT patients with FN for UTIs based on conflicting society guidelines [ 4–6 ].…”

mentioning

confidence: 99%

Utility of Urine Cultures During Febrile Neutropenia Workup in Hematopoietic Stem Cell Transplantation Recipients Without Urinary Symptoms

Tran

Palmer

Moore

et al. 2023

Open Forum Infectious Diseases

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Impact of discontinuing routine fluoroquinolone prophylaxis in neutropenic allogeneic haematopoietic stem cell transplant recipients: an observational study

Stern,

Henig,

Cohen

et al. 2024

Journal of Antimicrobial Chemotherapy

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Background Uncertainty exists as to the role of fluoroquinolone (FQ) prophylaxis for patients undergoing allogeneic haematopoietic stem cell transplantation (HSCT) in the era of rising antibiotic resistance. Objectives We aimed to evaluate rates of bloodstream infections (BSI), resistance patterns and outcomes of patients after discontinuing routine FQ prophylaxis administration. Methods All adult recipients of first HSCT from 2017 to 2020 were retrospectively included and classified according to time of HSCT as FQ group (HSCT January 2017–December 2018) or no FQ group (January 2019–December 2020). The primary outcome was Gram-negative (GN) BSI from day −7 to 30 days post-HSCT. The independent association between the study period and BSI was assessed using survival analysis, and adjusting for confounders. Results We included 254 patients, 130 (51%) and 124 (49%) in the FQ and no FQ groups, respectively. Compared to the FQ group, no FQ had significantly more GN BSI (21% versus 33%, P = 0.027) and the median time to first GN BSI was significantly shorter [4 (IQR 1–8) days versus 6 (1–10) days, P = 0.009]. Following adjustment, FQ prophylaxis remained associated with lower hazard for GN BSI (hazard ratio 0.57, 95% CI 0.34–0.93). Eighty-two GN BSI episodes had FQ susceptibility testing. More GN BSI episodes were FQ resistant in the FQ group (68.9% versus 41.6%, P = 0.021). No significant difference was found for 30-day mortality, time to first febrile neutropenia and time to first broad-spectrum antibiotics between the groups (P was not significant). Conclusions FQ prophylaxis is associated with fewer GN BSI in the early post-HSCT period even in high FQ resistance settings, with FQ resistance rates reaching >60% following prophylaxis.

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Febrile Neutropenia in Transplant Recipients

Cited by 3 publications

References 127 publications

Yield of repeat blood cultures in acute myeloid leukemia patients with febrile neutropenia and bacteremia following allogeneic hematopoietic stem cell transplant

Yield of repeat blood cultures in acute myeloid leukemia patients with febrile neutropenia and bacteremia following allogeneic hematopoietic stem cell transplant

Utility of Urine Cultures During Febrile Neutropenia Workup in Hematopoietic Stem Cell Transplantation Recipients Without Urinary Symptoms

Impact of discontinuing routine fluoroquinolone prophylaxis in neutropenic allogeneic haematopoietic stem cell transplant recipients: an observational study

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