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Single Positive Commensal Blood Culture in hospital setting is associated with higher mortality after hematopoietic stem cell transplantation
Affiliations- Department of Hematology, Oncology and Internal Diseases, Medical University of Warsaw, Warszawa, Poland
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Abstract
Background
Single positive staphylococcal blood culture in a hematopoietic stem cell transplantation (HSCT) recipient is generally regarded as contamination. Such a blood culture (BC) does not fill the criteria for Laboratory-Confirmed Bloodstream Infection (LCBI) and could be described as Single Positive Commensal Blood Culture. The aim of this retrospective cohort analysis was to determine the clinical significance of SPCBC in HSCT recipients.
Methods
206 patients transplanted between 2007 and 2013 were followed until January 2015.
Results
The 100-day survival for patients without positive BC was 99.6% compared with 83.9% for LCBI and 82.8% for SPCBC (p=0.0036). The 5-year overall survival (5yOS) was 67.1% for patients without positive BC, 44.9% for LCBI, 34.0% for SPCBC (p<0.0001). The per-day risk of developing SPCBC was identical in autologous and allogenic transplantation. SPCBC remained a significant factor for reduced 5yOS after HSCT in the univariate analysis (HR 2.52, 1.26–5.02, p=0.0001) as well as in the multivariate analysis (HR 2.21, 1.26–3.87, p=0.006). SPCBC consisted solely of different Staphylococcus species with dominance of Staphylococcus epidermidis (64% of SPCBC).
Conclusion
To our knowledge this is the first report that specifically shows that short- and long-term survival after HSCT is significantly lower in patients who experience an episode of SPCBC with Staphylococcus spp. during HSCT hospitalization.
Abstract
Background
Single positive staphylococcal blood culture in a hematopoietic stem cell transplantation (HSCT) recipient is generally regarded as contamination. Such a blood culture (BC) does not fill the criteria for Laboratory-Confirmed Bloodstream Infection (LCBI) and could be described as Single Positive Commensal Blood Culture. The aim of this retrospective cohort analysis was to determine the clinical significance of SPCBC in HSCT recipients.
Methods
206 patients transplanted between 2007 and 2013 were followed until January 2015.
Results
The 100-day survival for patients without positive BC was 99.6% compared with 83.9% for LCBI and 82.8% for SPCBC (p=0.0036). The 5-year overall survival (5yOS) was 67.1% for patients without positive BC, 44.9% for LCBI, 34.0% for SPCBC (p<0.0001). The per-day risk of developing SPCBC was identical in autologous and allogenic transplantation. SPCBC remained a significant factor for reduced 5yOS after HSCT in the univariate analysis (HR 2.52, 1.26–5.02, p=0.0001) as well as in the multivariate analysis (HR 2.21, 1.26–3.87, p=0.006). SPCBC consisted solely of different Staphylococcus species with dominance of Staphylococcus epidermidis (64% of SPCBC).
Conclusion
To our knowledge this is the first report that specifically shows that short- and long-term survival after HSCT is significantly lower in patients who experience an episode of SPCBC with Staphylococcus spp. during HSCT hospitalization.
Keywords
Hematopoietic stem cell transplantation; Sepsis; Staphylococcus epidermidis; Laboratory-Confirmed Bloodstream Infection
About this articleTitle
Single Positive Commensal Blood Culture in hospital setting is associated with higher mortality after hematopoietic stem cell transplantation
Journal
Issue
Pages
40-47
Published online
2017-01-01
Page views
104
Article views/downloads
113
DOI
10.1016/j.achaem.2016.11.004
Bibliographic record
Acta Haematol Pol 2017;48(1):40-47.
Keywords
Hematopoietic stem cell transplantation
Sepsis
Staphylococcus epidermidis
Laboratory-Confirmed Bloodstream Infection
Authors
Krzysztof Bogusz
Emilian Snarski
Patrycja Rusicka
Kazimierz Hałaburda
Tigran Torosian
Małgorzata Rokicka
Grzegorz Basak
Monika Paluszewska
Piotr Boguradzki
Grzegorz Charliński
Magdalena Tormanowska
Wiesław Wiktor Jędrzejczak