Multidrug resistant bacteremia in hematopoietic stem cell transplant recipients.
Journal
La Tunisie medicale
ISSN: 2724-7031
Titre abrégé: Tunis Med
Pays: Tunisia
ID NLM: 0413766
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
entrez:
26
4
2021
pubmed:
27
4
2021
medline:
29
10
2021
Statut:
ppublish
Résumé
Bacteremia become fearsome in hematopoietic stem cell transplant (HSCT) recipients with the emergence of multidrug-resistant (MDR) strains. Our purpose was to investigate the prevalence of MDR bacteremia in HSCT recipients at the Tunisian National Bone Marrow Transplant Center, associated factors and attributable mortality rate. Our retrospective study (January 2010-December 2017) included all MDR bacteremia in the Hematology department. MDR rods were: extended spectrum beta-lactamase producing Enterobacterales (ESBL-E), P. aeruginosa and A. baumannii resistant to at least three families of antibiotics, methicillin-resistant S. aureus (MRSA) and vancomycin resistant E. faecium (VRE). The prevalence of MDR bacteremia among HSCT recipients was 5.9% (48/816) with a stable trend over time (rs=0.18). Neutropenia, prior hospitalization, prior antibiotherapy and prior colonization with MDR pathogens were observed in 59%, 58%, 48% and 31% of cases, respectively. Imipenem was the most prescribed first-line antibiotic (50%). The attributable mortality rate was 13%. MDR bacteria (n=48) belonged to ESBL-E (60%), P. aeruginosa (19%), A. baumannii (13%), MRSA (4%) and VRE (4%). For ESBL-E and P. aeruginosa, the rates of antibiotic resistance were respectively, 17% and 44% to imipenem, 31% and 56% to amikacin and 15% and 0% to colistin. Strains of A. baumannii were susceptible only to colistin. The MRSA (n=2) were resistant to ciprofloxacin and gentamicin and susceptible to glycopeptides. The VRE (n=2) were susceptible to linezolid and tigecycline. Low prevalence of MDR bacteremia in HSCT recipients but high attributable mortality rate, requiring reinforcement of hygiene measures.
Sections du résumé
BACKGROUND
BACKGROUND
Bacteremia become fearsome in hematopoietic stem cell transplant (HSCT) recipients with the emergence of multidrug-resistant (MDR) strains.
AIM
OBJECTIVE
Our purpose was to investigate the prevalence of MDR bacteremia in HSCT recipients at the Tunisian National Bone Marrow Transplant Center, associated factors and attributable mortality rate.
METHODS
METHODS
Our retrospective study (January 2010-December 2017) included all MDR bacteremia in the Hematology department. MDR rods were: extended spectrum beta-lactamase producing Enterobacterales (ESBL-E), P. aeruginosa and A. baumannii resistant to at least three families of antibiotics, methicillin-resistant S. aureus (MRSA) and vancomycin resistant E. faecium (VRE).
RESULTS
RESULTS
The prevalence of MDR bacteremia among HSCT recipients was 5.9% (48/816) with a stable trend over time (rs=0.18). Neutropenia, prior hospitalization, prior antibiotherapy and prior colonization with MDR pathogens were observed in 59%, 58%, 48% and 31% of cases, respectively. Imipenem was the most prescribed first-line antibiotic (50%). The attributable mortality rate was 13%. MDR bacteria (n=48) belonged to ESBL-E (60%), P. aeruginosa (19%), A. baumannii (13%), MRSA (4%) and VRE (4%). For ESBL-E and P. aeruginosa, the rates of antibiotic resistance were respectively, 17% and 44% to imipenem, 31% and 56% to amikacin and 15% and 0% to colistin. Strains of A. baumannii were susceptible only to colistin. The MRSA (n=2) were resistant to ciprofloxacin and gentamicin and susceptible to glycopeptides. The VRE (n=2) were susceptible to linezolid and tigecycline.
CONCLUSION
CONCLUSIONS
Low prevalence of MDR bacteremia in HSCT recipients but high attributable mortality rate, requiring reinforcement of hygiene measures.
Identifiants
pubmed: 33899198
pii: /article-medicale-tunisie.php?article=3856
pmc: PMC8636969
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
269-276Références
Transpl Infect Dis. 2005 Mar;7(1):11-7
pubmed: 15984943
Clin Infect Dis. 2006 Apr 15;42 Suppl 4:S153-63
pubmed: 16544266
Bone Marrow Transplant. 2007 Jun;39(12):775-81
pubmed: 17438585
Biol Blood Marrow Transplant. 2017 Feb;23(2):333-339
pubmed: 27826061
Virulence. 2016 Apr 2;7(3):280-97
pubmed: 27002635
Int J Antimicrob Agents. 2013 Nov;42(5):403-9
pubmed: 24071027
Diagn Microbiol Infect Dis. 2017 Aug;88(4):335-341
pubmed: 28529091
Leuk Lymphoma. 2013 Apr;54(4):799-806
pubmed: 22916826
Haematologica. 2013 Dec;98(12):1826-35
pubmed: 24323983
Clin Infect Dis. 2017 Nov 13;65(11):1819-1828
pubmed: 29020364
Mediterr J Hematol Infect Dis. 2015 Jul 01;7(1):e2015045
pubmed: 26185610
Front Oncol. 2014 Jul 14;4:186
pubmed: 25072028
J Hosp Infect. 2018 Sep;100(1):83-91
pubmed: 29530743
Front Microbiol. 2017 Mar 27;8:497
pubmed: 28396656
Lancet Infect Dis. 2008 Dec;8(12):751-62
pubmed: 19022191
Am J Hematol. 2016 Nov;91(11):1076-1081
pubmed: 27428072
Clin Microbiol Infect. 2014 Dec;20(12):1357-62
pubmed: 24980276
Am J Infect Control. 2013 Jul;41(7):642-4
pubmed: 23375574
Clin Infect Dis. 2015 Sep 1;61(5):853-5
pubmed: 26021991
Lancet Oncol. 2014 Dec;15(13):e606-e619
pubmed: 25456379
Antimicrob Agents Chemother. 2017 Jul 25;61(8):
pubmed: 28584145
Transpl Infect Dis. 2014 Dec;16(6):887-96
pubmed: 25298044
BMC Infect Dis. 2017 Jul 17;17(1):500
pubmed: 28716109
Pediatr Infect Dis J. 2013 Jan;32(1):17-22
pubmed: 22935871
Clin Infect Dis. 2009 Jul 1;49(1):1-45
pubmed: 19489710
Front Cell Infect Microbiol. 2015 Feb 12;5:11
pubmed: 25729741
J Infect. 2006 Sep;53(3):190-8
pubmed: 16352338
Am J Infect Control. 2015 Sep 1;43(9):960-4
pubmed: 26082260
J Infect Dev Ctries. 2015 Oct 29;9(10):1100-7
pubmed: 26517485
Int J Antimicrob Agents. 2013 Jun;41(6):527-35
pubmed: 23590898
Braz J Med Biol Res. 2009 Mar;42(3):289-93
pubmed: 19287908
Antimicrob Agents Chemother. 2010 Mar;54(3):1160-4
pubmed: 20086165
Eur J Clin Microbiol Infect Dis. 2017 Jul;36(7):1261-1268
pubmed: 28181033