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Bacterial Bloodstream Infections after Allogeneic Hematopoietic Stem Cell Transplantation: Etiology, Risk Factors and Outcome in a Single-Center Study

Background—Allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients are subject to major risks for bacterial bloodstream infections (BSIs), including emergent multidrug-resistant (MDR) organisms, which still represent the main cause of morbidity and mortality in transplanted patients. Me...

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Autores principales: Gill, Jessica, Busca, Alessandro, Cinatti, Natascia, Passera, Roberto, Dellacasa, Chiara Maria, Giaccone, Luisa, Dogliotti, Irene, Manetta, Sara, Corcione, Silvia, De Rosa, Francesco Giuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10054102/
https://www.ncbi.nlm.nih.gov/pubmed/36985315
http://dx.doi.org/10.3390/microorganisms11030742
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author Gill, Jessica
Busca, Alessandro
Cinatti, Natascia
Passera, Roberto
Dellacasa, Chiara Maria
Giaccone, Luisa
Dogliotti, Irene
Manetta, Sara
Corcione, Silvia
De Rosa, Francesco Giuseppe
author_facet Gill, Jessica
Busca, Alessandro
Cinatti, Natascia
Passera, Roberto
Dellacasa, Chiara Maria
Giaccone, Luisa
Dogliotti, Irene
Manetta, Sara
Corcione, Silvia
De Rosa, Francesco Giuseppe
author_sort Gill, Jessica
collection PubMed
description Background—Allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients are subject to major risks for bacterial bloodstream infections (BSIs), including emergent multidrug-resistant (MDR) organisms, which still represent the main cause of morbidity and mortality in transplanted patients. Methods: We performed an observational, retrospective, single-center study on patients undergoing allo-HSCT between 2004 and 2020 at the Stem Cell Transplant Unit in Turin to assess the incidence, etiology, and outcomes of BSIs and to explore any risk factors for bacteriaemia. Results: We observed a total of 178 bacterial BSIs in our cohort of 563 patients, resulting in a cumulative incidence of 19.4%, 23.8%, and 28.7% at 30, 100, and 365 days, respectively. Among isolated bacteria, 50.6% were Gram positive (GPB), 41.6% were Gram negative (GNB), and 7.9% were polymicrobial infections. Moreover, BSI occurrence significantly influenced 1-year overall survival. High and very high Disease Risk Index (DRI), an haploidentical donor, and antibacterial prophylaxis were found as results as independent risk factors for bacterial BSI occurrence in multivariate analysis. Conclusions: In our experience, GNB have overwhelmed GPB, and fluoroquinolone prophylaxis has contributed to the emergence of MDR pathogens. Local resistance patterns and patients’ characteristics should therefore be considered for better management of bacteremia in patients receiving an allogeneic HSCT.
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spelling pubmed-100541022023-03-30 Bacterial Bloodstream Infections after Allogeneic Hematopoietic Stem Cell Transplantation: Etiology, Risk Factors and Outcome in a Single-Center Study Gill, Jessica Busca, Alessandro Cinatti, Natascia Passera, Roberto Dellacasa, Chiara Maria Giaccone, Luisa Dogliotti, Irene Manetta, Sara Corcione, Silvia De Rosa, Francesco Giuseppe Microorganisms Article Background—Allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients are subject to major risks for bacterial bloodstream infections (BSIs), including emergent multidrug-resistant (MDR) organisms, which still represent the main cause of morbidity and mortality in transplanted patients. Methods: We performed an observational, retrospective, single-center study on patients undergoing allo-HSCT between 2004 and 2020 at the Stem Cell Transplant Unit in Turin to assess the incidence, etiology, and outcomes of BSIs and to explore any risk factors for bacteriaemia. Results: We observed a total of 178 bacterial BSIs in our cohort of 563 patients, resulting in a cumulative incidence of 19.4%, 23.8%, and 28.7% at 30, 100, and 365 days, respectively. Among isolated bacteria, 50.6% were Gram positive (GPB), 41.6% were Gram negative (GNB), and 7.9% were polymicrobial infections. Moreover, BSI occurrence significantly influenced 1-year overall survival. High and very high Disease Risk Index (DRI), an haploidentical donor, and antibacterial prophylaxis were found as results as independent risk factors for bacterial BSI occurrence in multivariate analysis. Conclusions: In our experience, GNB have overwhelmed GPB, and fluoroquinolone prophylaxis has contributed to the emergence of MDR pathogens. Local resistance patterns and patients’ characteristics should therefore be considered for better management of bacteremia in patients receiving an allogeneic HSCT. MDPI 2023-03-14 /pmc/articles/PMC10054102/ /pubmed/36985315 http://dx.doi.org/10.3390/microorganisms11030742 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gill, Jessica
Busca, Alessandro
Cinatti, Natascia
Passera, Roberto
Dellacasa, Chiara Maria
Giaccone, Luisa
Dogliotti, Irene
Manetta, Sara
Corcione, Silvia
De Rosa, Francesco Giuseppe
Bacterial Bloodstream Infections after Allogeneic Hematopoietic Stem Cell Transplantation: Etiology, Risk Factors and Outcome in a Single-Center Study
title Bacterial Bloodstream Infections after Allogeneic Hematopoietic Stem Cell Transplantation: Etiology, Risk Factors and Outcome in a Single-Center Study
title_full Bacterial Bloodstream Infections after Allogeneic Hematopoietic Stem Cell Transplantation: Etiology, Risk Factors and Outcome in a Single-Center Study
title_fullStr Bacterial Bloodstream Infections after Allogeneic Hematopoietic Stem Cell Transplantation: Etiology, Risk Factors and Outcome in a Single-Center Study
title_full_unstemmed Bacterial Bloodstream Infections after Allogeneic Hematopoietic Stem Cell Transplantation: Etiology, Risk Factors and Outcome in a Single-Center Study
title_short Bacterial Bloodstream Infections after Allogeneic Hematopoietic Stem Cell Transplantation: Etiology, Risk Factors and Outcome in a Single-Center Study
title_sort bacterial bloodstream infections after allogeneic hematopoietic stem cell transplantation: etiology, risk factors and outcome in a single-center study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10054102/
https://www.ncbi.nlm.nih.gov/pubmed/36985315
http://dx.doi.org/10.3390/microorganisms11030742
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