open access

Vol 53, No 2 (2022)
Original research article
Submitted: 2021-10-26
Accepted: 2022-03-17
Published online: 2022-04-13
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Assessment of colonization and infection epidemiology in patients undergoing autologous hematopoietic stem cell transplantation: a single-center study

Kinga Michalina Krawiec1, Magdalena Czemerska1, Piotr Stelmach1, Agnieszka Wierzbowska1, Agnieszka Pluta1
DOI: 10.5603/AHP.a2022.0015
·
Acta Haematol Pol 2022;53(2):133-140.
Affiliations
  1. Department of Hematology, Medical University of Lodz, 2 Ciolkowskiego St, 93-510 Lodz, Poland

open access

Vol 53, No 2 (2022)
ORIGINAL RESEARCH ARTICLE
Submitted: 2021-10-26
Accepted: 2022-03-17
Published online: 2022-04-13

Abstract

Introduction: Infections are one of the main causes of early death after autologous hematopoietic stem cell transplantation (auto-HSCT).

Material and methods: We present a single-center retrospective analysis of colonization and infection epidemiology in 115 patients with median age 63 years (range 21–72), who underwent auto-HSCT in 2017 or 2018 in the course of multiple myeloma [79.1% (n = 91)], Hodgkin lymphoma [18.3% (n = 21)] and non-Hodgkin lymphoma [2.6% (n = 3)].

Results: Colonization was observed in 40.9% of patients before auto-HSCT, the most common location being the urinary tract — 54.3%. Multi-drug resistant bacteria (MDR) accounted for 20.9% of positive colonization cultures before auto-HSCT.

In the post-transplantation period, infections occurred in 77.4% of patients after auto-HSCT. Bacteremia was observed in 43.5% of patients and it was mostly caused by methicillin-resistant coagulase-negative Staphylococcus epidermidis (MRCNSE) — 27.6%. Infection of the skin near the central vascular catheter was found in 18.3% of patients, urinary tract infections in 11.3%, and gastrointestinal infections in 20.9%. MDR pathogens accounted for 65.2%. The most common of these was methicillin-resistant coagulase-negative Staphylococcus (MRCNS) — 73.9%. Fungal and viral infections were reported in 21.7% and 7%, respectively. The median duration of empirical and targeted antibiotic therapy was 5 (range 1–20) and 7 (range 4–31) days, respectively. Death due to septic shock occurred in 2/115 (1.7%) patients during the neutropenia period.

Conclusions: Evaluation of the epidemiology of colonization and infection in patients undergoing auto-HSCT can be an effective tool in providing control and therapy for infections in HSCT recipients. Such knowledge is also essential in monitoring potential pathogen transmission and helping to improve local infection management standards.

Abstract

Introduction: Infections are one of the main causes of early death after autologous hematopoietic stem cell transplantation (auto-HSCT).

Material and methods: We present a single-center retrospective analysis of colonization and infection epidemiology in 115 patients with median age 63 years (range 21–72), who underwent auto-HSCT in 2017 or 2018 in the course of multiple myeloma [79.1% (n = 91)], Hodgkin lymphoma [18.3% (n = 21)] and non-Hodgkin lymphoma [2.6% (n = 3)].

Results: Colonization was observed in 40.9% of patients before auto-HSCT, the most common location being the urinary tract — 54.3%. Multi-drug resistant bacteria (MDR) accounted for 20.9% of positive colonization cultures before auto-HSCT.

In the post-transplantation period, infections occurred in 77.4% of patients after auto-HSCT. Bacteremia was observed in 43.5% of patients and it was mostly caused by methicillin-resistant coagulase-negative Staphylococcus epidermidis (MRCNSE) — 27.6%. Infection of the skin near the central vascular catheter was found in 18.3% of patients, urinary tract infections in 11.3%, and gastrointestinal infections in 20.9%. MDR pathogens accounted for 65.2%. The most common of these was methicillin-resistant coagulase-negative Staphylococcus (MRCNS) — 73.9%. Fungal and viral infections were reported in 21.7% and 7%, respectively. The median duration of empirical and targeted antibiotic therapy was 5 (range 1–20) and 7 (range 4–31) days, respectively. Death due to septic shock occurred in 2/115 (1.7%) patients during the neutropenia period.

Conclusions: Evaluation of the epidemiology of colonization and infection in patients undergoing auto-HSCT can be an effective tool in providing control and therapy for infections in HSCT recipients. Such knowledge is also essential in monitoring potential pathogen transmission and helping to improve local infection management standards.

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Keywords

colonization, infections, auto-HSCT

About this article
Title

Assessment of colonization and infection epidemiology in patients undergoing autologous hematopoietic stem cell transplantation: a single-center study

Journal

Acta Haematologica Polonica

Issue

Vol 53, No 2 (2022)

Article type

Original research article

Pages

133-140

Published online

2022-04-13

Page views

477

Article views/downloads

87

DOI

10.5603/AHP.a2022.0015

Bibliographic record

Acta Haematol Pol 2022;53(2):133-140.

Keywords

colonization
infections
auto-HSCT

Authors

Kinga Michalina Krawiec
Magdalena Czemerska
Piotr Stelmach
Agnieszka Wierzbowska
Agnieszka Pluta

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