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- Title
Colonization by Extended-Spectrum β-Lactamase-Producing Enterobacterales and Bacteremia in Hematopoietic Stem Cell Transplant Recipients.
- Authors
Gonçalves, Luiza Arcas; Anjos, Beatriz Barbosa; Tavares, Bruno Melo; Marchi, Ana Paula; Côrtes, Marina Farrel; Higashino, Hermes Ryoiti; de Carvalho Moraes, Bruna del Guerra; Bampi, José Victor Bortolotto; Pinheiro, Liliane Dantas; Spadao, Fernanda de Souza; Rocha, Vanderson; Guimarães, Thais; Costa, Silvia Figueiredo
- Abstract
Background: Assessing the risk of multidrug-resistant colonization and infections is pivotal for optimizing empirical therapy in hematopoietic stem cell transplants (HSCTs). Limited data exist on extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) colonization in this population. This study aimed to assess whether ESBL-E colonization constitutes a risk factor for ESBL-E bloodstream infection (BSI) and to evaluate ESBL-E colonization in HSCT recipients. Methods: A retrospective analysis of ESBL-E colonization and BSI in HSCT patients was conducted from August 2019 to June 2022. Weekly swabs were collected and cultured on chromogenic selective media, with PCR identifying the β-lactamase genes. Pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing (WGS) assessed the colonizing strains' similarities. Results: Of 222 evaluated HSCT patients, 59.45% were colonized by ESBL-E, with 48.4% at admission. The predominant β-lactamase genes were blaTEM (52%) and blaSHV (20%). PFGE analysis did not reveal predominant clusters in 26 E. coli and 15 K. pneumoniae strains. WGS identified ST16 and ST11 as the predominant sequence types among K. pneumoniae. Thirty-three patients developed thirty-five Enterobacterales-BSIs, with nine being third-generation cephalosporin-resistant. No association was found between ESBL-E colonization and ESBL-BSI (p = 0.087). Conclusions: Although the patients presented a high colonization rate of ESBL-E upon admission, no association between colonization and infection were found. Thus, it seems that ESBL screening is not a useful strategy to assess risk factors and guide therapy for ESBL-BSI in HSCT-patients.
- Subjects
HEMATOPOIETIC stem cells; STEM cell transplantation; PULSED-field gel electrophoresis; WHOLE genome sequencing; BACTEREMIA
- Publication
Antibiotics (2079-6382), 2024, Vol 13, Issue 5, p448
- ISSN
2079-6382
- Publication type
Article
- DOI
10.3390/antibiotics13050448