Blood Res.  2016 Jun;51(2):102-106. 10.5045/br.2016.51.2.102.

Risk factors for mortality in patients with bloodstream infections during the pre-engraftment period after hematopoietic stem cell transplantation

• Stoma I
• Karpov I
• Milanovich N
• Uss A
• Iskrov I

• KMID: 2309211
• DOI: http://doi.org/10.5045/br.2016.51.2.102

Abstract

BACKGROUND
Bloodstream infections (BSI) remain a frequent complication during the pre-engraftment period after hematopoietic stem cell transplantation (HSCT), resulting in high mortality rates. This study evaluated risk factors for mortality in hematopoietic stem cell transplant recipients with BSI in the pre-engraftment period.
METHODS
This prospective case control study was performed at the Center of Hematology and Bone Marrow Transplantation in Minsk, Republic of Belarus. Data relating to patient age and gender, date and type of transplantation, conditioning chemotherapy regimen, microorganisms isolated from blood, and antibacterial therapy were prospectively collected from all hematopoietic stem cell recipients with microbiologically proven cases of BSI in the pre-engraftment period. The primary outcome was all-cause 30-day mortality after onset of febrile neutropenia.
RESULTS
A total of 135 adult patients with microbiologically proven BSI after HSCT were studied, with 65.2% of cases caused by gram-negative microorganisms and 21.5% by non-fermenting bacteria. Inadequate empiric antibacterial therapy and isolation of carbapenem-resistant non-fermenting gram-negative bacteria (Acinetobacter baumannii and Pseudomonas aeruginosa) were independently associated with increased all-cause 30-day mortality in these patients.
CONCLUSION
The risk factors for mortality in adult patients with BSI in the pre-engraftment period after HSCT were inadequacy of empirical antibacterial therapy and isolation of carbapenem-resistant A. baumannii or P. aeruginosa.

Keyword

Hematopoietic stem cell transplantation; Bloodstream infection; Risk factors; Antibacterial therapy

MeSH Terms

Adult
Bacteria
Bone Marrow Transplantation
Case-Control Studies
Drug Therapy
Febrile Neutropenia
Gram-Negative Bacteria
Hematology
Hematopoietic Stem Cell Transplantation*
Hematopoietic Stem Cells*
Humans
Mortality*
Prospective Studies
Pseudomonas
Republic of Belarus
Risk Factors*
Transplant Recipients

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