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. 2017 Jun 20;9(1):e2017036.
doi: 10.4084/MJHID.2017.036. eCollection 2017.

Bacterial Blood Stream Infections Negatively Impact on Outcome of Patients Treated with Allogeneic Stem Cell Transplantation: 6 Years Single-Centre Experience

Michele Malagola  1 , Bendetta Rambaldi  1 , Giuseppe Ravizzola  2 , Chiara Cattaneo  3 , Erika Borlenghi  3 , Nicola Polverelli  1 , Alessandro Turra  1 , Enrico Morello  1 , Cristina Skert  1 , Valeria Cancelli  1 , Federica Cattina  1 , Giorgio Giannetta  1 , Simona Bernardi  1 , Simone Perucca  1 , Camillo Almici  4 , Aldo Roccaro  5 , Liana Signorini  6 , Roberto Stellini  6 , Francesco Castelli  6 , Arnaldo Caruso  2 , Domenico Russo  1
Affiliations

Bacterial Blood Stream Infections Negatively Impact on Outcome of Patients Treated with Allogeneic Stem Cell Transplantation: 6 Years Single-Centre Experience

Michele Malagola et al. Mediterr J Hematol Infect Dis. .

Abstract

Background: Blood stream infections (BSIs) represent a major complication of allo-SCT and are a major cause of morbidity and mortality during and after bone marrow aplasia.

Objectives: The objective of this study was to describe the incidence and outcome of BSIs in a cohort of patients submitted to allo-SCT, in order to track changes of the epidemiology and bacteria resistance.

Methods: We retrospectively analyzed the microbiological data of 162 patients allotransplanted in Brescia University Hospital, over a period of 6 years.

Results: Eighty patients experienced a BSIs for a total of 119 isolates. In 77 cases (65%) a Gram positive bacteria was isolated, being coagulase negative Staphilococci the most frequent species (77% of the cases). In 42 cases (35%) a Gram negative bacteria was isolated (E. coli 57% and P. aeruginosa 24%). Fluoroquinolones resistance was frequent (90% for S. epidermidis, 92% for E. coli, 90% for P. aeruginosa). Methycillin resistance of S. epidermidis was 100%, 76% of E. coli were ESBL positive and among P. aeruginosa resistance to carbapenems was 40%. The 2 years overall survival of patients with BSIs vs patients without BSIs was 46% vs 60% (HR1,48, p=0,07). P. aeruginosa and E. coli were the species with the highest mortality (50% and 33%, respectively).

Conclusions: These data confirm that BSIs, mainly sustained by Gram positive bacteria, are frequent in allotransplanted patients (50% of the cases) and may influence the outcome of allotransplanted patients, being antibiotics resistance highly frequent among these bacteria.

Keywords: Antimicrobical Resistance; Bacterial Infections; Bone Marrow Transplantation.

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Conflict of interest statement

Competing interests: The authors have declared that no competing interests exist.

Figures

Figure 1A
Figure 1A
Overall survival of the 162 allotransplanted patients according to presence or not of a BSI.
Figure 1B
Figure 1B
Transplant related mortality of the 162 allotransplanted patients according to presence or not of a BSI. CI= Cumulative Incidence; TRM = Transplant Related Mortality
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