Intercontinental study on pre-engraftment and post-engraftment Gram-negative rods bacteremia in hematopoietic stem cell transplantation patients: Risk factors and association with mortality
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Intercontinental study on pre-engraftment and post-engraftment Gram-negative rods bacteremia in hematopoietic stem cell transplantation patients: Risk factors and association with mortality. / Averbuch, Diana; Tridello, Gloria; Hoek, Jennifer; Mikulska, Malgorzata; Pabst, Thomas; Yaňez San Segundo, Lucrecia; Akan, Hamdi; Özçelik, Tülay; Donnini, Irene; Klyasova, Galina; Botelho de Sousa, Aida; Zuckerman, Tsila; Tecchio, Cristina; de la Camara, Rafael; Aki, Sahika Zeynep; Ljungman, Per; Gülbas, Zafer; Nicolas-Virelizier, Emmanuelle; Calore, Elisabetta; Perruccio, Katia; Ram, Ron; Annaloro, Claudio; Martino, Rodrigo; Avni, Batia; Shaw, Peter J; Jungova, Alexandra; Codeluppi, Katia; O'Brien, Tracey; Waszczuk-Gajda, Anna; Batlle, Montserrat; Pouli, Anastasia; Lueck, Catherina; Gil, Lidia; Iacobelli, Simona; Styczynski, Jan; Engelhard, Dan; Cesaro, Simone.
In: J INFECTION, Vol. 81, No. 6, 12.2020, p. 882-894.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Intercontinental study on pre-engraftment and post-engraftment Gram-negative rods bacteremia in hematopoietic stem cell transplantation patients: Risk factors and association with mortality
AU - Averbuch, Diana
AU - Tridello, Gloria
AU - Hoek, Jennifer
AU - Mikulska, Malgorzata
AU - Pabst, Thomas
AU - Yaňez San Segundo, Lucrecia
AU - Akan, Hamdi
AU - Özçelik, Tülay
AU - Donnini, Irene
AU - Klyasova, Galina
AU - Botelho de Sousa, Aida
AU - Zuckerman, Tsila
AU - Tecchio, Cristina
AU - de la Camara, Rafael
AU - Aki, Sahika Zeynep
AU - Ljungman, Per
AU - Gülbas, Zafer
AU - Nicolas-Virelizier, Emmanuelle
AU - Calore, Elisabetta
AU - Perruccio, Katia
AU - Ram, Ron
AU - Annaloro, Claudio
AU - Martino, Rodrigo
AU - Avni, Batia
AU - Shaw, Peter J
AU - Jungova, Alexandra
AU - Codeluppi, Katia
AU - O'Brien, Tracey
AU - Waszczuk-Gajda, Anna
AU - Batlle, Montserrat
AU - Pouli, Anastasia
AU - Lueck, Catherina
AU - Gil, Lidia
AU - Iacobelli, Simona
AU - Styczynski, Jan
AU - Engelhard, Dan
AU - Cesaro, Simone
N1 - Copyright © 2020 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
PY - 2020/12
Y1 - 2020/12
N2 - OBJECTIVES: We present here data on Gram-negative rods bacteremia (GNRB) rates, risk factors and associated mortality.METHODS: Data on GNRB episodes were prospectively collected in 65 allo-/67 auto-HSCT centers in 24 countries (Europe, Asia, Australia). In patients with and without GNRB, we compared: demography, underlying disease, HSCT-related data, center` fluoroquinolone prophylaxis (FQP) policy and accreditation status, and involvement of infection control team (ICT).RESULTS: The GNRB cumulative incidence among 2818 allo-HSCT was: pre-engraftment (pre-eng-allo-HSCT), 8.4 (95% CI 7-9%), post-engraftment (post-eng-allo-HSCT), 5.8% (95%CI: 5-7%); among 3152 auto-HSCT, pre-eng-auto-HSCT, 6.6% (95%CI: 6-7%), post-eng-auto-HSCT, 0.7% (95%CI: 0.4-1.1%). GNRB, especially MDR, was associated with increased mortality. Multivariate analysis revealed the following GNRB risk factors: (a) pre-eng-allo-HSCT: south-eastern Europe center location, underlying diseases not at complete remission, and cord blood source; (b) post-eng-allo-HSCT: center location not in northwestern Europe; underlying non-malignant disease, not providing FQP and never accredited. (c) pre-eng-auto-HSCT: older age, autoimmune and malignant (vs. plasma cell) disease, and ICT absence.CONCLUSIONS: Benefit of FQP should be explored in prospective studies. Increased GNRB risk in auto-HSCT patients transplanted for autoimmune diseases is worrying. Infection control and being accredited are possibly protective against bacteremia. GNRB are associated with increased mortality.
AB - OBJECTIVES: We present here data on Gram-negative rods bacteremia (GNRB) rates, risk factors and associated mortality.METHODS: Data on GNRB episodes were prospectively collected in 65 allo-/67 auto-HSCT centers in 24 countries (Europe, Asia, Australia). In patients with and without GNRB, we compared: demography, underlying disease, HSCT-related data, center` fluoroquinolone prophylaxis (FQP) policy and accreditation status, and involvement of infection control team (ICT).RESULTS: The GNRB cumulative incidence among 2818 allo-HSCT was: pre-engraftment (pre-eng-allo-HSCT), 8.4 (95% CI 7-9%), post-engraftment (post-eng-allo-HSCT), 5.8% (95%CI: 5-7%); among 3152 auto-HSCT, pre-eng-auto-HSCT, 6.6% (95%CI: 6-7%), post-eng-auto-HSCT, 0.7% (95%CI: 0.4-1.1%). GNRB, especially MDR, was associated with increased mortality. Multivariate analysis revealed the following GNRB risk factors: (a) pre-eng-allo-HSCT: south-eastern Europe center location, underlying diseases not at complete remission, and cord blood source; (b) post-eng-allo-HSCT: center location not in northwestern Europe; underlying non-malignant disease, not providing FQP and never accredited. (c) pre-eng-auto-HSCT: older age, autoimmune and malignant (vs. plasma cell) disease, and ICT absence.CONCLUSIONS: Benefit of FQP should be explored in prospective studies. Increased GNRB risk in auto-HSCT patients transplanted for autoimmune diseases is worrying. Infection control and being accredited are possibly protective against bacteremia. GNRB are associated with increased mortality.
KW - Aged
KW - Asia
KW - Australia
KW - Bacteremia/epidemiology
KW - Europe/epidemiology
KW - Europe, Eastern
KW - Hematopoietic Stem Cell Transplantation/adverse effects
KW - Humans
KW - Prospective Studies
KW - Retrospective Studies
KW - Risk Factors
KW - Transplantation, Homologous
U2 - 10.1016/j.jinf.2020.11.002
DO - 10.1016/j.jinf.2020.11.002
M3 - SCORING: Journal article
C2 - 33186673
VL - 81
SP - 882
EP - 894
JO - J INFECTION
JF - J INFECTION
SN - 0163-4453
IS - 6
ER -
