We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Microbiota Predict Infections and Acute Graft-Versus-Host Disease After Pediatric Allogeneic Hematopoietic Stem Cell Transplantation.
- Authors
Margolis, Elisa B; Alfaro, Gabriela Maron; Sun, Yilun; Dallas, Ronald H; Allison, Kim J; Ferrolino, Jose; Ross, Hailey S; Davis, Amy E; Jia, Qidong; Turner, Paige; Mackay, Victoria; Morin, Cara E; Triplett, Brandon M; Klein, Eileen J; Englund, Janet A; Tang, Li; Hayden, Randall T
- Abstract
Background Despite preventive measures, infections continue to pose significant risks to pediatric allogeneic hematopoietic cell transplantation (allo-HCT) recipients. The gut microbiota has been linked to clinical outcomes following adult allo-HCT. This study evaluated whether similar disruptions or differing microbiota patterns were associated with infection risk in pediatric allo-HCT. Methods In a prospective observational study, fecal samples were obtained from 74 children before conditioning and upon neutrophil recovery. Microbiome signatures identified through sequencing were examined for their associations with infections or acute graft-versus-host disease (aGVHD) in the first-year post-HCT using Cox proportional hazards analysis. Results Microbiome disruption in adults, did not predict infection risk in pediatric allo-HCT. Unique microbiota signatures were associated with different infections or aGVHD. A ratio of strict and facultative anaerobes (eg, Lachnoclostridium , Parabacteroides) prior to conditioning predicted bacteremia risk (Cox hazard ratio [HR], 3.89). A distinct ratio of oral (eg, Rothia , Veillonella) to intestinal anaerobes (eg, Anaerobutyricum , Romboutsia) at neutrophil recovery predicted likelihood of bacterial infections (Cox HR, 1.81) and viral enterocolitis (Cox HR, 1.96). Conclusions Interactions between medical interventions, pediatric hosts, and microbial communities contribute to microbiota signatures that predict infections. Further multicenter study is necessary to validate the generalizability of these ratios as biomarkers.
- Subjects
HEMATOPOIETIC stem cell transplantation; GRAFT versus host disease; ACUTE diseases
- Publication
Journal of Infectious Diseases, 2023, Vol 228, Issue 5, p627
- ISSN
0022-1899
- Publication type
Article
- DOI
10.1093/infdis/jiad190