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European Journal of Clinical Microbiology & Infectious Diseases
Published in: European Journal of Clinical Microbiology & Infectious Diseases 5/2019

01-05-2019 | Antibiotic | Original Article

G-CSF-primed haplo-identical HSCT with intensive immunosuppressive and myelosuppressive treatments does not increase the risk of pre-engraftment bloodstream infection: a multicenter case–control study

Authors: Jinhua Ren, Qiaoxian Lin, Weimin Chen, Congmeng Lin, Yuxin Zhang, Cunrong Chen, Shaozhen Chen, Xiaohong Yuan, Ping Chen, Xiaofeng Luo, Yun Lin, Lvying Shen, Mengxian Guo, Qiuru Chen, Min Xiao, Yongquan Chen, Xueqiong Wu, Yanling Zeng, Zhizhe Chen, Xudong Ma, Jianda Hu, Ting Yang

Published in: European Journal of Clinical Microbiology & Infectious Diseases | Issue 5/2019

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Abstract

A multicenter retrospective study in 131 patients (44 females/87 males) with hematological disorders who underwent G-CSF-primed/haplo-identical (Haplo-ID) (n = 76) or HLA-identical (HLA-ID) HSCT (n = 55) from February 2013 to February 2016 was conducted to compare the incidence and risk factors for pre-engraftment bloodstream infection (PE-BSI). In the Haplo-ID group, 71/76 patients with high-risk (n = 28) or relapsed/refractory hematological malignancies (n = 43) received FA5-BUCY conditioning (NCT02328950). All received trimethoprim–sulfamethoxazole (TMP–SMX) prophylaxis. Blood cultures and catheter tip cultures were obtained to confirm the BSI. PE-BSI was detected in 24/131 HSCT patients (18/76 in Haplo-ID and 6/55 in HLA-ID) after 28 febrile neutropenic episodes. Among 28 isolates for the 24 patients, 21 (75%) were Gneg bacteria, 6 (21.4%) Gpos and 1 (3.6%) fungi. Bacteria sources were central venous line infection (7/29.2%), gastroenteritis (6/25%), lower respiratory tract infection (LRTI; 5/20.8%), perianal skin infection (4/16.7%), and unknown (2/8.3%). The duration of neutropenia (P = 0.046) and previous Gneg bacteremia (P = 0.037) were important risk factors by univariate analysis, while the type of HSCT was not. A trend of TMP–SMX-resistant BSI in both groups may be due to routine antibacterial prophylaxis strategies. Our data show that G-CSF-primed Haplo-ID HSCT did not increase the risk of PE-BSI, even with intensive immunosuppressive treatments.
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Metadata
Title
G-CSF-primed haplo-identical HSCT with intensive immunosuppressive and myelosuppressive treatments does not increase the risk of pre-engraftment bloodstream infection: a multicenter case–control study
Authors
Jinhua Ren
Qiaoxian Lin
Weimin Chen
Congmeng Lin
Yuxin Zhang
Cunrong Chen
Shaozhen Chen
Xiaohong Yuan
Ping Chen
Xiaofeng Luo
Yun Lin
Lvying Shen
Mengxian Guo
Qiuru Chen
Min Xiao
Yongquan Chen
Xueqiong Wu
Yanling Zeng
Zhizhe Chen
Xudong Ma
Jianda Hu
Ting Yang
Publication date
01-05-2019
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Clinical Microbiology & Infectious Diseases / Issue 5/2019
Print ISSN: 0934-9723
Electronic ISSN: 1435-4373
DOI
https://doi.org/10.1007/s10096-019-03482-6

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