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. 2024 Jun 4:17:2249-2260.
doi: 10.2147/IDR.S463868. eCollection 2024.

Effectiveness of Pre-Transplant Screening for High-Priority Multidrug-Resistant Pathogens on Pre-Engraftment Infections After Hematopoietic Stem Cell Transplantation

Noha A Kamel  1 , Mahmoud S Abdalla  2 , Amer Al Ali  3 , Mohammad Y Alshahrani  4 , Khaled M Aboshanab  5   6 , Mervat I El Borhamy  1   7
Affiliations

Effectiveness of Pre-Transplant Screening for High-Priority Multidrug-Resistant Pathogens on Pre-Engraftment Infections After Hematopoietic Stem Cell Transplantation

Noha A Kamel et al. Infect Drug Resist. .

Abstract

Objective: Owing to the rising incidence of multidrug-resistant organisms (MDRO) and the high mortality rates associated with such bacterial infections post-hematopoietic stem cell transplantation (HSCT), we investigated the MDRO colonization rate prior to transplantation using an active surveillance approach and determined its impact on subsequent infection during the pre-engraftment period.

Methods: A single-center observational study was conducted, and surveillance cultures from multiple body sites, including the rectum, nasal cavity, and groin, were performed at admission to determine MDRO colonization. Serological tests were used to detect certain viruses and toxoplasmosis before HSCT.

Results: In the pre-transplant setting, 59 MDRO were recovered from the 40 HSCT recipients. Of the 59 isolates recovered from one or more body sites, 29 were positive for methicillin-resistant Staphylococcus aureus (MRSA), 7 for carbapenem-resistant Enterobacterales (CRE), and 23 were positive for extended-spectrum β-lactamase (ESBLs). Serological assessment before HSCT revealed active or reactivation of latent infection with cytomegalovirus (7.5%), Epstein-Barr virus (EBV; 5%), and Toxoplasma gondii (2.5%) among HSCT patients. In terms of factors associated with pre-engraftment infections, the type of transplant (p=0.04) was statistically significant, whereas other factors, such as age, sex, and underlying conditions, were not. In post-transplant settings, bloodstream infections (BSIs) were documented in 2 allogeneic HSCT patients (5%), and the isolated microorganisms were ESBL-producing E. coli and non-MDR Acinetobacter baumannii.

Conclusion: Active screening cultures are a helpful tool for identifying patients colonized by MDRO or relevant viruses before HSCT, and for predicting those at risk of developing subsequent pre-engraftment infections. Additionally, active screening may aid in predicting those who are likely to develop subsequent pre-engraftment infections Our findings highlight the importance of pre-transplant screening for high-priority multidrug-resistant pathogens and the application of infection control interventions after HSCT.

Keywords: CRE; ESBLs; MRSA; pre-engraftment infections; pre-transplant screening.

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Conflict of interest statement

The authors declare that they have no competing interests in this work.

Figures

Figure 1
Figure 1
Distribution of Multidrug-resistance organisms (MDRO) pre- and post-HSCT.
Figure 2
Figure 2
Antimicrobial resistance profile of CRE and ESBLs post-HSCT.
See this image and copyright information in PMC

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References

    1. Snowden JA, Sánchez-Ortega I, Corbacioglu S. et al. Indications for haematopoietic cell transplantation for haematological diseases, solid tumours and immune disorders: current practice in Europe, 2022. Bone Marrow Transplant. 2022;57(8):1217–1239. doi:10.1038/s41409-022-01691-w - DOI - PMC - PubMed
    1. Khaddour K, Hana CK, Mewawalla P. Hematopoietic stem cell transplantation. StatPearls [Internet]. StatPearls Publishing. Treasure Island (FL), USA: StatPearls Publishing. 2022. 1–25. PMID: 30725636. Available from: https://www.ncbi.nlm.nih.gov/books/NBK536951/. Accessed May 28 2024. - PubMed
    1. Christopeit M, Schmidt-Hieber M, Sprute R, et al. Prophylaxis, diagnosis and therapy of infections in patients undergoing high-dose chemotherapy and autologous haematopoietic stem cell transplantation. 2020 update of the recommendations of the infectious diseases working party (AGIHO) of the German society of hematology and medical oncology (DGHO). Ann Hematol. 2021;100(2):321–336. doi:10.1007/s00277-020-04297-8 - DOI - PMC - PubMed
    1. Nucci M, Anaissie E. Infections after high-dose chemotherapy and autologous hematopoietic stem cell transplantation. Infect Hematol. 2014;27:49–61.
    1. Rojas-Rechy MH, Gaytán-Morales F, Sánchez-Ponce Y, et al. Herpesvirus screening in childhood hematopoietic transplant reveals high systemic inflammation in episodes of multiple viral detection and an EBV association with elevated IL-1β, IL-8 and graft-versus-host disease. Microorganisms. 2022;10(8):1685. doi:10.3390/microorganisms10081685 - DOI - PMC - PubMed