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- Title
Evaluation of colonization and infection profile in allogeneic hematopoietic stem cell transplantation recipients.
- Authors
Krawiec, Kinga Michalina; Strzałka, Piotr; Stańczak, Kamila; Czemerska, Magdalena; Szmigielska-Kapłon, Anna; Grzybowska-Izydorczyk, Olga; Wierzbowska, Agnieszka; Pluta, Agnieszka
- Abstract
Introduction: Infections are one of the main causes of death after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Material and methods: We conducted a single-center retrospective analysis of colonization and infection epidemiology in 44 patients who underwent matched related donor (MRD) allo-HSCT between 2012 and 2022. Results: Colonization was observed in 84.1% of patients before allo-HSCT. The most common location was the anus, colonized in 55.4% of patients, mostly by Klebsiella pneumoniae ESBL(+) -- 28.6%. Multi-drug resistant bacteria (MDR) accounted for 50.7% of positive colonization cultures before allo-HSCT. In the post-transplantation period (i.e. up to 100 days after allo-HSCT), infections occurred in 86.4% of patients. Bacteremia was observed in 47.7% of patients, mostly caused by methicillin-resistant coagulase-negative Staphylococcus epidermidis -- 39.4%. Infection of the skin and soft tissue near the central line was found in 27.3% of patients, urinary tract infections in 56.8%, and gastrointestinal infections in 38.6%. Fungal infections were reported in 31.8%. MDR pathogens accounted for 58.1% of all infecting pathogens. The most common resistance was extended-spectrum beta-lactamase (ESBL), accounting for 50.8% of all MDR strains. Viral reactivations were detected in 29.5% of patients. 59.5% of colonized patients developed an infection with the pathogen responsible for their previous colonization. Infections with such pathogens were significantly more frequent in colonized patients than with de novo pathogens (p = 0.04). Conclusions: The results of the presented study highlight the role of colonization assessment as a tool to identify patients at high risk of developing post-transplant infections, guiding the possibility of efficient targeted antibiotic therapy.
- Subjects
STEM cell transplantation; HEMATOPOIETIC stem cell transplantation; MULTIDRUG resistance in bacteria; URINARY tract infections; SOFT tissue infections
- Publication
Acta Haematologica Polonica, 2024, Vol 55, Issue 2, p112
- ISSN
0001-5814
- Publication type
Article
- DOI
10.5603/ahp.98671