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Erschienen in: Annals of Hematology 2/2014

01.02.2014 | Original Article

Incidence, risk factors, and outcome of bacteremia following autologous hematopoietic stem cell transplantation in 720 adult patients

verfasst von: José Luis Piñana, Pau Montesinos, Rodrigo Martino, Lourdes Vazquez, Montserrat Rovira, Javier López, Montserrat Batlle, Ángela Figuera, Pere Barba, Juan José Lahuerta, Guillermo Debén, Cristina Perez-Lopez, Raimundo García, Pedro Rosique, Esperanza Lavilla, Adriana Gascón, David Martínez-Cuadrón, Miguel Ángel Sanz

Erschienen in: Annals of Hematology | Ausgabe 2/2014

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Abstract

Bacteremia is the most frequent infectious complication during neutropenia in patients receiving autologous hematopoietic stem cell transplantation (ASCT). The objective of this study was to analyze the incidence, characteristics, risk factors, and outcome of bacteremia during the early period after ASCT. A total of 720 patients undergoing ASCT in two observational prospective consecutive multicenter studies of the Programa Español para el Tratamiento de las Hemopatías group were analyzed. Bacteremia occurred in 20 % of patients. Coagulase-negative Staphylococcus was the most frequent (66 %) among the gram-positive agents and Escherichia coli (49 %) among the gram-negative agents. Multivariate analysis showed that the length of neutropenia <1 × 109/L (more than 9 days) [relative risk (RR) of 2.6, p < 0.001] was the sole risk factor for overall bacteremia. We identified the length of neutropenia <1 × 109/L (more than 9 days) (RR 4.98, p < 0.001) and the use of prophylactic fluoroquinolones (RR 0.46, p < 0.01) as specific risk factors for gram-negative bacteremia. Risk factors for gram-positive bacteremia were the use of total parenteral nutrition (RR 1.92, p < 0.01) and deep neutropenia (<0.1 × 109/L), with duration over 5 days (RR 1.67, p < 0.027). Bacteremia showed an increased morbidity with no impact on neither overall nor infectious related mortality. The identification of such risk factors may be helpful to implement prophylactic and therapeutic risk-adapted strategies to reduce the incidence of bacteremia in ASCT.
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Metadaten
Titel
Incidence, risk factors, and outcome of bacteremia following autologous hematopoietic stem cell transplantation in 720 adult patients
verfasst von
José Luis Piñana
Pau Montesinos
Rodrigo Martino
Lourdes Vazquez
Montserrat Rovira
Javier López
Montserrat Batlle
Ángela Figuera
Pere Barba
Juan José Lahuerta
Guillermo Debén
Cristina Perez-Lopez
Raimundo García
Pedro Rosique
Esperanza Lavilla
Adriana Gascón
David Martínez-Cuadrón
Miguel Ángel Sanz
Publikationsdatum
01.02.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Annals of Hematology / Ausgabe 2/2014
Print ISSN: 0939-5555
Elektronische ISSN: 1432-0584
DOI
https://doi.org/10.1007/s00277-013-1872-4

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