Skip to main content
Erschienen in: Indian Journal of Hematology and Blood Transfusion 2/2017

29.06.2016 | Original Article

Bacteremia During Early Post-allogeneic Hematopoietic Stem Cell Transplantation Period: A Single Center Experience

verfasst von: Amro Mohamed Sedky El-Ghammaz

Erschienen in: Indian Journal of Hematology and Blood Transfusion | Ausgabe 2/2017

Einloggen, um Zugang zu erhalten

Abstract

Bacteremia is a significant complication of allogeneic hematopoietic stem cell transplantation (HSCT). We aimed to study bacteremia occurring during early post-transplant period at Bone Marrow Transplantation Unit of Ain Shams University regarding its risk factors and impact on survival. Patients performing allogeneic HSCT were followed up for occurrence of bacteremia. Survival status was assessed at 180 days post-transplant. Bacteremia occurred in 53.3 % of patients. On univariate analysis, CD34 +ve cell dose (P = 0.004), duration of neutropenia (P = 0.018), time interval between day of stem cell infusion and day of neutrophil engraftment (P = 0.043) and > 1 apheresis days (P = 0.040) were associated with higher rates of bacteremia. On multivariate analysis, CD34 +ve cell dose (P = 0.002) and apheresis day number (P = 0.038) remained significant. There was significant difference between patients who developed bacteremia and those who did not regarding overall survival (OS) (P = 0.042). Patients developing bacteremia caused by Gram negative bacteria (GNB) had lower OS than Gram positive bacteria (GPB) (P < 0.001). In conclusion, stem cell dose and apheresis day number influence bacteremia risk. Also, Gram negative bacteremia has negative impact on allogeneic transplant recipient survival rates.
Literatur
1.
Zurück zum Zitat Kedia S, Acharya PS, Mohammad F, Nguyen H, Asti D, Mehta S, Pant M, Mobarakai N (2013) Infectious complications of hematopoietic stem cell transplantation. J Stem Cell Res Ther S3:002 Kedia S, Acharya PS, Mohammad F, Nguyen H, Asti D, Mehta S, Pant M, Mobarakai N (2013) Infectious complications of hematopoietic stem cell transplantation. J Stem Cell Res Ther S3:002
2.
Zurück zum Zitat Collin BA, Leather HL, Wingard JR, Ramphal R (2001) Evolution, incidence, and susceptibility of bacterial bloodstream isolates from 519 bone marrow transplant patients. Clin Inf Dis 33:947–953CrossRef Collin BA, Leather HL, Wingard JR, Ramphal R (2001) Evolution, incidence, and susceptibility of bacterial bloodstream isolates from 519 bone marrow transplant patients. Clin Inf Dis 33:947–953CrossRef
3.
Zurück zum Zitat Worth LJ, Slavin MA (2009) Bloodstream infections in haematol-ogy: risks and new challenges for prevention. Blood Rev 23:113–122CrossRefPubMed Worth LJ, Slavin MA (2009) Bloodstream infections in haematol-ogy: risks and new challenges for prevention. Blood Rev 23:113–122CrossRefPubMed
4.
Zurück zum Zitat Ortega M, Rovira M, Almela M, Marco F, de la Bellacasa JP, Martínez JA, Carreras E, Mensa J (2005) Bacterial and fungal bloodstream isolates from 796 hematopoietic stem cell transplant recipients between 1991 and 2000. Ann Hematol 84:40–46CrossRefPubMed Ortega M, Rovira M, Almela M, Marco F, de la Bellacasa JP, Martínez JA, Carreras E, Mensa J (2005) Bacterial and fungal bloodstream isolates from 796 hematopoietic stem cell transplant recipients between 1991 and 2000. Ann Hematol 84:40–46CrossRefPubMed
5.
Zurück zum Zitat Guthrie KA, Yong M, Frieze D, Corey L, Fredricks DN (2009) The impact of a change in antibacterial prophylaxis from ceftazidime to levofloxacin in allogeneic hematopoietic cell transplantation. Bone Marrow Transpl 45:675–681CrossRef Guthrie KA, Yong M, Frieze D, Corey L, Fredricks DN (2009) The impact of a change in antibacterial prophylaxis from ceftazidime to levofloxacin in allogeneic hematopoietic cell transplantation. Bone Marrow Transpl 45:675–681CrossRef
6.
Zurück zum Zitat Mikulska M, Del Bono V, Raiola AM, Bruno B, Gualandi F, Occhini D, di Grazia C, Frassoni F, Bacigalupo A, Viscoli C (2009) Blood stream infections in allogeneic hematopoietic stem cell transplant recipients: reemergence of gram-negative rods and increasing antibiotic resistance. Biol Blood Marrow Transpl 15:47–53CrossRef Mikulska M, Del Bono V, Raiola AM, Bruno B, Gualandi F, Occhini D, di Grazia C, Frassoni F, Bacigalupo A, Viscoli C (2009) Blood stream infections in allogeneic hematopoietic stem cell transplant recipients: reemergence of gram-negative rods and increasing antibiotic resistance. Biol Blood Marrow Transpl 15:47–53CrossRef
7.
Zurück zum Zitat Almyroudis NG, Fuller A, Jakubowski A, Sepkowitz K, Jaffe D, Small TN, Kiehn TE, Pamer E, Papanicolaou GA (2005) Pre- and post-engraftment bloodstream infection rates and associated mortality in allogeneic hematopoietic stem cell transplant recipients. Transpl Infect Dis 7:11–17CrossRefPubMed Almyroudis NG, Fuller A, Jakubowski A, Sepkowitz K, Jaffe D, Small TN, Kiehn TE, Pamer E, Papanicolaou GA (2005) Pre- and post-engraftment bloodstream infection rates and associated mortality in allogeneic hematopoietic stem cell transplant recipients. Transpl Infect Dis 7:11–17CrossRefPubMed
8.
Zurück zum Zitat Poutsiaka DD, Price LL, Ucuzian A, Chan GW, Miller KB, Snydman DR (2007) Blood stream infection after hematopoietic stem cell transplantation is associated with increased mortality. Bone Marrow Transpl 40:63–70CrossRef Poutsiaka DD, Price LL, Ucuzian A, Chan GW, Miller KB, Snydman DR (2007) Blood stream infection after hematopoietic stem cell transplantation is associated with increased mortality. Bone Marrow Transpl 40:63–70CrossRef
9.
Zurück zum Zitat Maschmeyer G, Ljungman P (2011) Infections in hematopoietic stem cell transplant recipients. In: Safdar A (ed) Principles and practice of cancer infectious diseases, current clinical oncology. Springer Science + Business Media, New York, pp 17–25CrossRef Maschmeyer G, Ljungman P (2011) Infections in hematopoietic stem cell transplant recipients. In: Safdar A (ed) Principles and practice of cancer infectious diseases, current clinical oncology. Springer Science + Business Media, New York, pp 17–25CrossRef
10.
Zurück zum Zitat Ramphal R (2004) Changes in the etiology of bacteremia in febrile neutropenic patients and the susceptibilities of the current-ly isolated pathogens. Clin Infect Dis 39(Suppl 1):S25–S31CrossRefPubMed Ramphal R (2004) Changes in the etiology of bacteremia in febrile neutropenic patients and the susceptibilities of the current-ly isolated pathogens. Clin Infect Dis 39(Suppl 1):S25–S31CrossRefPubMed
11.
Zurück zum Zitat Wisplinghoff H, Seifert H, Wenzel RP, Edmond MB (2003) Current trends in the epidemiology of nosocomial bloodstream infections in patients with hematological malignancies and solid neoplasms in hospitals in the United States. Clin In-fect Dis 36:1103–1110CrossRef Wisplinghoff H, Seifert H, Wenzel RP, Edmond MB (2003) Current trends in the epidemiology of nosocomial bloodstream infections in patients with hematological malignancies and solid neoplasms in hospitals in the United States. Clin In-fect Dis 36:1103–1110CrossRef
12.
Zurück zum Zitat Jugo J, Kennedy R, Crowe MJ, Lamrock G, McClurg RB, Rooney PJ, Morris TC, Johnston PG (2002) Trends in bacteraemia on the haematology and oncology units of a UK tertiary re-ferral hospital. J Hosp Infect 50:48–55CrossRefPubMed Jugo J, Kennedy R, Crowe MJ, Lamrock G, McClurg RB, Rooney PJ, Morris TC, Johnston PG (2002) Trends in bacteraemia on the haematology and oncology units of a UK tertiary re-ferral hospital. J Hosp Infect 50:48–55CrossRefPubMed
13.
Zurück zum Zitat Gonçalves TL, Benvegnú DM, Bonfanti G (2009) Specific factors influence the success of autologous and allogeneic hematopoietic stem cell transplantation. Oxid Med Cell Longev 2:82–87CrossRefPubMedPubMedCentral Gonçalves TL, Benvegnú DM, Bonfanti G (2009) Specific factors influence the success of autologous and allogeneic hematopoietic stem cell transplantation. Oxid Med Cell Longev 2:82–87CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Crawford J, Dale DC, Lyman GH (2004) Chemotherapy-induced neutropenia: risks, consequences, and new directions for its management. Cancer 100:228–237CrossRefPubMed Crawford J, Dale DC, Lyman GH (2004) Chemotherapy-induced neutropenia: risks, consequences, and new directions for its management. Cancer 100:228–237CrossRefPubMed
15.
Zurück zum Zitat Ninin E, Milpied N, Moreau P, Andre-Richet B, Morineau N, Mahe B, Vigier M, Imbert BM, Morin O, Harousseau JL, Richet H (2001) Longitudinal study of bacterial, viral, and fungal infections in adult recipients of bone marrow transplants. Clin Infect Dis 33:41–47CrossRefPubMed Ninin E, Milpied N, Moreau P, Andre-Richet B, Morineau N, Mahe B, Vigier M, Imbert BM, Morin O, Harousseau JL, Richet H (2001) Longitudinal study of bacterial, viral, and fungal infections in adult recipients of bone marrow transplants. Clin Infect Dis 33:41–47CrossRefPubMed
16.
Zurück zum Zitat Sparrelid E, Hagglund H, Remberger M, Ringden O, Lonnqvist B, Ljungman P, Andersson J (1998) Bacteraemia during the aplastic phase after allogeneic bone marrow transplantation is associated with early death from invasive fungal infection. Bone Marrow Transpl 22:795–800CrossRef Sparrelid E, Hagglund H, Remberger M, Ringden O, Lonnqvist B, Ljungman P, Andersson J (1998) Bacteraemia during the aplastic phase after allogeneic bone marrow transplantation is associated with early death from invasive fungal infection. Bone Marrow Transpl 22:795–800CrossRef
17.
Zurück zum Zitat Therriault BL, Wilson JW, Barreto JN, Estes LL (2010) Characterization of bacterial infections in allogeneic hematopoietic stem cell transplant recipients who received prophylactic levofloxacin with either penicillin or doxycycline. Mayo Clin Proc 85:711–718CrossRefPubMedPubMedCentral Therriault BL, Wilson JW, Barreto JN, Estes LL (2010) Characterization of bacterial infections in allogeneic hematopoietic stem cell transplant recipients who received prophylactic levofloxacin with either penicillin or doxycycline. Mayo Clin Proc 85:711–718CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Busca A, Cavecchia I, Locatelli F, D’Ardia S, De Rosa FG, Marmont F, Ciccone G, Baldi I, Serra R, Gaido E, Falda M (2012) Blood stream infections after allogeneic stem cell transplantation: a single-center experience with the use of levofloxacin prophylaxis. Transpl Infect Dis 14:40–48CrossRefPubMed Busca A, Cavecchia I, Locatelli F, D’Ardia S, De Rosa FG, Marmont F, Ciccone G, Baldi I, Serra R, Gaido E, Falda M (2012) Blood stream infections after allogeneic stem cell transplantation: a single-center experience with the use of levofloxacin prophylaxis. Transpl Infect Dis 14:40–48CrossRefPubMed
19.
Zurück zum Zitat Rosa RG, dos Santos RP, Goldani LZ (2014) Mortality related to coagulase-negative staphylococcal bacteremia in febrile neutropenia: A cohort study. Can J Infect Dis Med Microbiol 25:e14–e17PubMedPubMedCentral Rosa RG, dos Santos RP, Goldani LZ (2014) Mortality related to coagulase-negative staphylococcal bacteremia in febrile neutropenia: A cohort study. Can J Infect Dis Med Microbiol 25:e14–e17PubMedPubMedCentral
20.
Zurück zum Zitat Frère P, Hermanne JP, Debouge MH, de Mol P, Fillet G, Beguin Y (2004) Bacteremia after hematopoietic stem cell transplantation: incidence and predictive value of surveillance cultures. Bone Marrow Transpl 33:745–749CrossRef Frère P, Hermanne JP, Debouge MH, de Mol P, Fillet G, Beguin Y (2004) Bacteremia after hematopoietic stem cell transplantation: incidence and predictive value of surveillance cultures. Bone Marrow Transpl 33:745–749CrossRef
21.
Zurück zum Zitat Ghazal SS, Stevens MP, Bearman GM, Edmond MB (2014) Utility of surveillance blood cultures in patients undergoing hematopoietic stem cell transplantation. Antimicrob Resist Infect Control 3:20CrossRefPubMedPubMedCentral Ghazal SS, Stevens MP, Bearman GM, Edmond MB (2014) Utility of surveillance blood cultures in patients undergoing hematopoietic stem cell transplantation. Antimicrob Resist Infect Control 3:20CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Oliveira AL, de Souza M, Carvalho-Dias VMH, Ruiz MA, Silla L, Yurie Tanaka P, Simoes BP, Trabasso P, Seber A, Lotfi CJ, Zanichelli MA, Araujo VR, Godoy C, Maiolino A, Urakawa P, Cunha CA, de Souza CA, Pasquini R, Nucci M (2007) Epidemiology of bacteremia and factors associated with multi-drug resistant gram-negative bacteremia in hematopoietic stem cell transplant recipients. Bone Marrow Transpl 39:775–781CrossRef Oliveira AL, de Souza M, Carvalho-Dias VMH, Ruiz MA, Silla L, Yurie Tanaka P, Simoes BP, Trabasso P, Seber A, Lotfi CJ, Zanichelli MA, Araujo VR, Godoy C, Maiolino A, Urakawa P, Cunha CA, de Souza CA, Pasquini R, Nucci M (2007) Epidemiology of bacteremia and factors associated with multi-drug resistant gram-negative bacteremia in hematopoietic stem cell transplant recipients. Bone Marrow Transpl 39:775–781CrossRef
23.
Zurück zum Zitat Mendes ET, Dulley F, Basso M, Batista MV, Coracin F, Guimaraes T, Shikanai-Yasuda MA, Levin AS, Costa SF (2012) Healthcare-associated infection in hematopoietic stem cell transplantation patients: risk factors and impact on outcome. Int J Infect Dis 16:e424–e428CrossRefPubMed Mendes ET, Dulley F, Basso M, Batista MV, Coracin F, Guimaraes T, Shikanai-Yasuda MA, Levin AS, Costa SF (2012) Healthcare-associated infection in hematopoietic stem cell transplantation patients: risk factors and impact on outcome. Int J Infect Dis 16:e424–e428CrossRefPubMed
24.
Zurück zum Zitat Cappellano P, Viscoli C, Bruzzi P, Van Lint MT, Pereira CAP, Bacigalupo A (2007) Epidemiology and risk factors for bloodstream infections after allogeneic hematopoietic stem cell transplantion. New Microb 30:89–99 Cappellano P, Viscoli C, Bruzzi P, Van Lint MT, Pereira CAP, Bacigalupo A (2007) Epidemiology and risk factors for bloodstream infections after allogeneic hematopoietic stem cell transplantion. New Microb 30:89–99
25.
Zurück zum Zitat Kwon JC, Kim SH, Choi JK, Cho SY, Park YJ, Park SH, Choi SM, Lee DG, Choi JH, Yoo JH (2013) Epidemiology and clinical features of bloodstream infections in hematology wards: one year experience at the catholic blood and marrow transplantation center. Infect Chemother 45:51–61CrossRefPubMedPubMedCentral Kwon JC, Kim SH, Choi JK, Cho SY, Park YJ, Park SH, Choi SM, Lee DG, Choi JH, Yoo JH (2013) Epidemiology and clinical features of bloodstream infections in hematology wards: one year experience at the catholic blood and marrow transplantation center. Infect Chemother 45:51–61CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Bittencourt H, Rocha V, Chevret S, Socie G, Esperou H, Devergie A, Dal Cortivo L, Marolleau J, Garnier F, Ribaud P, Gluckman E (2002) Association of CD34 cell dose with hematopoietic recovery, infections, and other outcomes after HLA-identical sibling bone marrow transplantation. Blood 99:2726–2733CrossRefPubMed Bittencourt H, Rocha V, Chevret S, Socie G, Esperou H, Devergie A, Dal Cortivo L, Marolleau J, Garnier F, Ribaud P, Gluckman E (2002) Association of CD34 cell dose with hematopoietic recovery, infections, and other outcomes after HLA-identical sibling bone marrow transplantation. Blood 99:2726–2733CrossRefPubMed
27.
Zurück zum Zitat Rajasekar R, Mathews V, Lakshmi KM, George B, Viswabandya A, Chandy M, Srivastava A (2009) Cellular Immune reconstitution and its impact on clinical outcome in children with β thalassemia major undergoing a matched related myeloablative allogeneic bone marrow transplant. Biol Blood Marrow Transpl 15:597–609CrossRef Rajasekar R, Mathews V, Lakshmi KM, George B, Viswabandya A, Chandy M, Srivastava A (2009) Cellular Immune reconstitution and its impact on clinical outcome in children with β thalassemia major undergoing a matched related myeloablative allogeneic bone marrow transplant. Biol Blood Marrow Transpl 15:597–609CrossRef
28.
29.
Zurück zum Zitat Almeida ID, Schmalfuss T, Rohsig LM, Goldani LZ (2012) Autologous transplant: microbial contamination of hematopoietic stem cell products. Braz J Infect Dis 16:345–350CrossRefPubMed Almeida ID, Schmalfuss T, Rohsig LM, Goldani LZ (2012) Autologous transplant: microbial contamination of hematopoietic stem cell products. Braz J Infect Dis 16:345–350CrossRefPubMed
30.
Zurück zum Zitat Majado MJ, Garcia-Hernandez A, Morales A, Gonzalez C, Martinez-Sanchez V, Menasalvas A, Rosique P, Rubio A, Sanz-Imedio E (2007) Influence of harvest bacterial contamination on autologous peripheral blood progenitor cells post-transplant. Bone Marrow Transpl 39:121–125CrossRef Majado MJ, Garcia-Hernandez A, Morales A, Gonzalez C, Martinez-Sanchez V, Menasalvas A, Rosique P, Rubio A, Sanz-Imedio E (2007) Influence of harvest bacterial contamination on autologous peripheral blood progenitor cells post-transplant. Bone Marrow Transpl 39:121–125CrossRef
31.
Zurück zum Zitat Abe R, Oda S, Sadahiro T, Nakamura M, Hirayama Y, Tateishi Y, Shinozaki K, Hirasawa H (2010) Gram-negative bacteremia induces greater magnitude of inflammatory response than Gram-positive bacteremia. Crit Care 14:R27CrossRefPubMedPubMedCentral Abe R, Oda S, Sadahiro T, Nakamura M, Hirayama Y, Tateishi Y, Shinozaki K, Hirasawa H (2010) Gram-negative bacteremia induces greater magnitude of inflammatory response than Gram-positive bacteremia. Crit Care 14:R27CrossRefPubMedPubMedCentral
Metadaten
Titel
Bacteremia During Early Post-allogeneic Hematopoietic Stem Cell Transplantation Period: A Single Center Experience
verfasst von
Amro Mohamed Sedky El-Ghammaz
Publikationsdatum
29.06.2016
Verlag
Springer India
Erschienen in
Indian Journal of Hematology and Blood Transfusion / Ausgabe 2/2017
Print ISSN: 0971-4502
Elektronische ISSN: 0974-0449
DOI
https://doi.org/10.1007/s12288-016-0703-x

Weitere Artikel der Ausgabe 2/2017

Indian Journal of Hematology and Blood Transfusion 2/2017 Zur Ausgabe

Alter verschlechtert Prognose bei Endometriumkarzinom

11.05.2024 Endometriumkarzinom Nachrichten

Ein höheres Alter bei der Diagnose eines Endometriumkarzinoms ist mit aggressiveren Tumorcharakteristika assoziiert, scheint aber auch unabhängig von bekannten Risikofaktoren die Prognose der Erkrankung zu verschlimmern.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Erhöhte Mortalität bei postpartalem Brustkrebs

07.05.2024 Mammakarzinom Nachrichten

Auch für Trägerinnen von BRCA-Varianten gilt: Erkranken sie fünf bis zehn Jahre nach der letzten Schwangerschaft an Brustkrebs, ist das Sterberisiko besonders hoch.

Hypertherme Chemotherapie bietet Chance auf Blasenerhalt

07.05.2024 Harnblasenkarzinom Nachrichten

Eine hypertherme intravesikale Chemotherapie mit Mitomycin kann für Patienten mit hochriskantem nicht muskelinvasivem Blasenkrebs eine Alternative zur radikalen Zystektomie darstellen. Kölner Urologen berichten über ihre Erfahrungen.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.