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International Journal of Hematology
Erschienen in:

22.10.2016 | Original Article

Bacteremia during neutropenic episodes in children undergoing hematopoietic stem cell transplantation with ciprofloxacin and penicillin prophylaxis

verfasst von: Worawut Choeyprasert, Suradej Hongeng, Usanarat Anurathapan, Samart Pakakasama

Erschienen in: International Journal of Hematology | Ausgabe 2/2017

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Abstract

Bacteremia during neutropenic episodes is a cause of morbidity and mortality in patients undergoing hematopoietic stem cell transplantation (HSCT). We have used oral ciprofloxacin and penicillin V, from the start of the conditioning regimen until engraftment, for the prophylaxis of bacterial infection. The objective of this study was to retrospectively analyze the prevalence of and risk factors for breakthrough bacteremia during neutropenic episodes in autologous and allogeneic HSCT patients. There were 215 patients enrolled, with a median age of 8.32 years (range 0.51–21.64 years) between 2002 and 2014. The common underlying diseases were thalassemia and acute leukemia. Bacteremia was documented in 33 patients (15.3 %), with 39 microorganisms isolated. Escherichia coli (28.2 %) and Streptococcus viridans (12.8 %) were the most commonly isolated Gram-negative and Gram-positive bacteria, respectively. Multidrug resistant strains were found in 32 and 14.3 % of Gram-negative and Gram-positive bacteria, respectively. Risk factors for bacteremia were receiving anti-thymocyte globulin (ATG) [odds ratio (OR) 2.44, 95 % confidence interval (CI) 1.06–5.65, P = 0.037] and umbilical cord blood as a stem cell graft (OR 6.60, 95 % CI 1.04–41.83, P = 0.045). In conclusion, the prevalence of bacteremia was 15.3 % and the use of ATG and cord blood were risk factors for bacteremia during neutropenic episodes.
Literatur
1.
Poutsiaka DD, Price LL, Ucuzian A, Chan GW, Miller KB, Snydman DR. Blood stream infection after hematopoietic stem cell transplantation is associated with increased mortality. Bone Marrow Transplant. 2007;40:63–70.CrossRefPubMed
2.
Mikulska M, Del Bono V, Raiola AM, Bruno B, Gualandi F, Occhini D, et al. Blood stream infections in allogeneic hematopoietic stem cell transplant recipients: reemergence of Gram-negative rods and increasing antibiotic resistance. Biol Blood Marrow Transplant. 2009;15:47–53.CrossRefPubMed
3.
Almyroudis NG, Fuller A, Jakubowski A, Sepkowitz K, Jaffe D, Small TN, et al. Pre- and post-engraftment bloodstream infection rates and associated mortality in allogeneic hematopoietic stem cell transplant recipients. Transpl Infect Dis. 2005;7:11–7.CrossRefPubMed
4.
Ortega M, Rovira M, Almela M, Marco F, de la Bellacasa JP, Martinez JA, et al. Bacterial and fungal bloodstream isolates from 796 hematopoietic stem cell transplant recipients between 1991 and 2000. Ann Hematol. 2005;84:40–6.CrossRefPubMed
5.
Guthrie KA, Yong M, Frieze D, Corey L, Fredricks DN. The impact of a change in antibacterial prophylaxis from ceftazidime to levofloxacin in allogeneic hematopoietic cell transplantation. Bone Marrow Transplant. 2010;45:675–81.CrossRefPubMed
6.
Tomblyn M, Chiller T, Einsele H, Gress R, Sepkowitz K, Storek J, et al. Guidelines for preventing infectious complications among hematopoietic cell transplant recipients: a global perspective. Bone Marrow Transplant. 2009;44:453–5.CrossRefPubMed
7.
Gafter-Gvili A, Fraser A, Paul M, Leibovici L. Meta-analysis: antibiotic prophylaxis reduces mortality in neutropenic patients. Ann Intern Med. 2005;142:979–95.CrossRefPubMed
8.
Freifeld AG, Bow EJ, Sepkowitz KA, Boeckh MJ, Ito JI, Mullen CA, et al. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america. Clin Infect Dis. 2011;52:e56–93.CrossRefPubMed
9.
Meunier F, Zinner SH, Gaya H, Calandra T, Viscoli C, Klastersky J, et al. Prospective randomized evaluation of ciprofloxacin versus piperacillin plus amikacin for empiric antibiotic therapy of febrile granulocytopenic cancer patients with lymphomas and solid tumors. The European Organization for Research on Treatment of Cancer International Antimicrobial Therapy Cooperative Group. Antimicrob Agents Chemother. 1991;35:873–8.CrossRefPubMedPubMedCentral
10.
International Antimicrobial Therapy Cooperative Group of the European. Organization for Research and Treatment of Cancer. Reduction of fever and streptococcal bacteremia in granulocytopenic patients with cancer. A trial of oral penicillin V or placebo combined with pefloxacin. JAMA. 1994;272:1183–9.CrossRef
11.
Kimura S, Akahoshi Y, Nakano H, Ugai T, Wada H, Yamasaki R, et al. Antibiotic prophylaxis in hematopoietic stem cell transplantation. A meta-analysis of randomized controlled trials. J Infect. 2014;69(1):13–25.CrossRefPubMed
12.
Cecinati V, Principi N, Brescia L, Esposito S. Antibiotic prophylaxis in children with cancer or who have undergone hematopoietic cell transplantation. Eur J Clin Microbiol Infect Dis. 2014;33:1–6.CrossRefPubMed
13.
Busca A, Cavecchia I, Locatelli F, D’Ardia S, De Rosa FG, Marmont F, et al. Blood stream infections after allogeneic stem cell transplantation: a single-center experience with the use of levofloxacin prophylaxis. Transpl Infect Dis. 2012;14:40–8.CrossRefPubMed
14.
Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug-resistant, extensively drug-resistant and pandrugresistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012;18:268–81.CrossRefPubMed
15.
Dell’Orto M, Rovelli A, Barzaghi A, Valsecchi MG, Silvestri D, Giltri G, et al. Febrile complications in the first 100 days after bone marrow transplantation in children: a single center’s experience. Pediatr Hematol Oncol. 1997;14:335–47.CrossRefPubMed
16.
Mullen CA, Nair J, Sandesh S, Chan KW. Fever and neutropenia in pediatric hematopoietic stem cell transplant patients. Bone Marrow Transplant. 2000;25:59–65.CrossRefPubMed
17.
Salazar R, Sola C, Maroto P, Tabernero JM, Brunet J, Verger G, et al. Infectious complications in 126 patients treated with high-dose chemotherapy and autologous peripheral blood stem cell transplantation. Bone Marrow Transplant. 1999;23:27–33.CrossRefPubMed
18.
Blennow O, Ljungman P, Sparrelid E, Mattsson J, Remberger M. Incidence, risk factors, and outcome of bloodstream infections during the pre-engraftment phase in 521 allogeneic hematopoietic stem cell transplantations. Transpl Infect Dis. 2014;16:106–14.CrossRefPubMed
19.
Kikuchi M, Akahoshi Y, Nakano H, Ugai T, Wada H, Yamasaki R, et al. Risk factors for pre- and post-engraftment bloodstream infections after allogeneic hematopoietic stem cell transplantation. Transpl Infect Dis. 2015;17:56–65.CrossRefPubMed
20.
Lopes LA, Veroneze I, Burgardt CI, Niebel Stier CJ. Prophylaxis with levofloxacin: impact on bacterial susceptibility and epidemiology in a hematopoietic stem cell transplant unit. Rev Bras Hematol Hemoter. 2014;36:35–42.CrossRefPubMedCentral
21.
Vossen JM, Heidt PJ, van den Berg H, Gerritsen EJ, Hermans J, Dooren LJ. Prevention of infection and graft-versus-host disease by suppression of intestinal microflora in children treated with allogeneic bone marrow transplantation. Eur J Clin Microbiol Infect Dis. 1990;9:14–23.CrossRefPubMed
22.
Dini G, Castagnola E, Comoli P, van Tol MJ, Vossen JM. Infections after stem cell transplantation in children: state of the art and recommendations. Bone Marrow Transplant. 2001;28(Suppl 1):S18–21.CrossRefPubMed
23.
Romano V, Castagnola E, Dallorso S, Lanino E, Calvi A, Silvestro S, et al. Bloodstream infections can develop late (after day 100) and/or in the absence of neutropenia in children receiving allogeneic bone marrow transplantation. Bone Marrow Transplant. 1999;23:271–5.CrossRefPubMed
24.
Kersun LS, Propert KJ, Lautenbach E, Bunin N, Demichele A. Early bacteremia in pediatric hematopoietic stem cell transplant patients on oral antibiotic prophylaxis. Pediatr Blood Cancer. 2005;45:162–9.CrossRefPubMed
25.
Sarashina T, Yoshida M, Iguchi A, Okubo H, Toriumi N, Suzuki D, et al. Risk factor analysis of bloodstream infection in pediatric patients after hematopoietic stem cell transplantation. J Pediatr Hematol Oncol. 2013;35:76–80.CrossRefPubMed
26.
Liu CY, Lai YC, Huang LJ, Yang YW, Chen TL, Hsiao LT, et al. Impact of bloodstream infections on outcome and the influence of prophylactic oral antibiotic regimens in allogeneic hematopoietic SCT recipients. Bone Marrow Transplant. 2011;46:1231–9.CrossRefPubMed
27.
Paterson DL. “Collateral damage” from cephalosporin or quinolone antibiotic therapy. Clin Infect Dis. 2004;38(Suppl 4):S341–5.CrossRefPubMed
28.
Therriault BL, Wilson JW, Barreto JN, Estes LL. Characterization of bacterial infections in allogeneic hematopoietic stem cell transplant recipients who received prophylactic levofloxacin with either penicillin or doxycycline. Mayo Clin Proc. 2010;85:711–8.CrossRefPubMedPubMedCentral
29.
Macesic N, Morrissey CO, Cheng AC, Spencer A, Peleg AY. Changing microbial epidemiology in hematopoietic stem cell transplant recipients: increasing resistance over a 9-year period. Transpl Infect Dis. 2014;16:887–96.CrossRefPubMed
30.
Bucaneve G, Micozzi A, Menichetti F, Martino P, Dionisi MS, Martinelli G, et al. Levofloxacin to prevent bacterial infection in patients with cancer and neutropenia. N Engl J Med. 2005;353:977–87.CrossRefPubMed
31.
Pepin J, Saheb N, Coulombe MA, Alary ME, Corriveau MP, Authier S, et al. Emergence of fluoroquinolones as the predominant risk factor for Clostridium difficile-associated diarrhea: a cohort study during an epidemic in Quebec. Clin Infect Dis. 2005;41:1254–60.CrossRefPubMed
32.
Wingard JR, Eldjerou L, Leather H. Use of antibacterial prophylaxis in patients with chemotherapy-induced neutropenia. Curr Opin Hematol. 2012;19:21–6.CrossRefPubMed
33.
Carratala J, Alcaide F, Fernandez-Sevilla A, Corbella X, Linares J, Gudiol F. Bacteremia due to viridans streptococci that are highly resistant to penicillin: increase among neutropenic patients with cancer. Clin Infect Dis. 1995;20:1169–73.CrossRefPubMed
34.
Krcmery V, Trupl J. Bacteraemia due to penicillin-resistant Streptococcus viridans in cancer patients, before and after prophylaxis with penicillin. Lancet. 1995;346:1362–3.CrossRefPubMed
35.
Bochud PY, Eggiman P, Calandra T, Van Melle G, Saghafi L, Francioli P. Bacteremia due to viridans streptococcus in neutropenic patients with cancer: clinical spectrum and risk factors. Clin Infect Dis. 1994;18:25–31.CrossRefPubMed
36.
Parody R, Martino R, Rovira M, Vazquez L, Vazquez MJ, de la Camara R, et al. Severe infections after unrelated donor allogeneic hematopoietic stem cell transplantation in adults: comparison of cord blood transplantation with peripheral blood and bone marrow transplantation. Biol Blood Marrow Transplant. 2006;12:734–48.CrossRefPubMed
37.
Myers GD, Krance RA, Weiss H, Kuehnle I, Demmler G, Heslop HE, et al. Adenovirus infection rates in pediatric recipients of alternate donor allogeneic bone marrow transplants receiving either antithymocyte globulin (ATG) or alemtuzumab (Campath). Bone Marrow Transplant. 2005;36:1001–8.CrossRefPubMed
38.
Brunstein CG, Weisdorf DJ, DeFor T, Barker JN, Tolar J, van Burik JA, et al. Marked increased risk of Epstein-Barr virus-related complications with the addition of antithymocyte globulin to a nonmyeloablative conditioning prior to unrelated umbilical cord blood transplantation. Blood. 2006;108:2874–80.CrossRefPubMedPubMedCentral
39.
Sauter C, Abboud M, Jia X, Heller G, Gonzales AM, Lubin M, et al. Serious infection risk and immune recovery after double-unit cord blood transplantation without antithymocyte globulin. Biol Blood Marrow Transplant. 2011;17(10):1460–71.CrossRefPubMedPubMedCentral
40.
Cohen J, Gandhi M, Naik P, et al. Increased incidence of EBV-related disease following paediatric stem cell transplantation with reduced-intensity conditioning. Br J Haematol. 2005;129:229–39.CrossRefPubMed
41.
Robin M, Marque-Juillet S, Scieux C, et al. Disseminated adenovirus infections after allogeneic hematopoietic stem cell transplantation: incidence, risk factors and outcome. Haematologica. 2007;92:1254–7.CrossRefPubMed
42.
Komanduri KV, St John LS, de Lima M, et al. Delayed immune reconstitution after cord blood transplantation is characterized by impaired thymopoiesis and late memory T-cell skewing. Blood. 2007;110:4543–51.CrossRefPubMedPubMedCentral
43.
Brown JA, Stevenson K, Kim HT, et al. Clearance of CMV viremia and survival after double umbilical cord blood transplantation in adults depends on reconstitution of thymopoiesis. Blood. 2010;115:4111–9.CrossRefPubMedPubMedCentral
44.
Lebranchu Y, Bridoux F, Buchler M, Le Meur Y, Etienne I, Toupance O, et al. Immunoprophylaxis with basiliximab compared with antithymocyte globulin in renal transplant patients receiving MMF-containing triple therapy. Am J Transplant. 2002;2:48–56.CrossRefPubMed
45.
Schwartz JJ, Ishitani MB, Weckwerth J, Morgenstern B, Milliner D, Stegall MD. Decreased incidence of acute rejection in adolescent kidney transplant recipients using antithymocyte induction and triple immunosuppression. Transplantation. 2007;84:715–21.CrossRefPubMed
46.
Clark G, Walsh G, Deshpande P, Koffman G. Improved efficacy of basiliximab over antilymphocyte globulin induction therapy in paediatric renal transplantation. Nephrol Dial Transplant. 2002;17:1304–9.CrossRefPubMed
47.
Palmer SM, Miralles AP, Lawrence CM, Gaynor JW, Davis RD, Tapson VF. Rabbit antithymocyte globulin decreases acute rejection after lung transplantation: results of a randomized, prospective study. Chest. 1999;116:127–33.CrossRefPubMed
Metadaten
Titel
Bacteremia during neutropenic episodes in children undergoing hematopoietic stem cell transplantation with ciprofloxacin and penicillin prophylaxis
verfasst von
Worawut Choeyprasert
Suradej Hongeng
Usanarat Anurathapan
Samart Pakakasama
Publikationsdatum
22.10.2016
Verlag
Springer Japan
Erschienen in
International Journal of Hematology / Ausgabe 2/2017
Print ISSN: 0925-5710
Elektronische ISSN: 1865-3774
DOI
https://doi.org/10.1007/s12185-016-2113-0

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