Impact of Gut Colonization by Antibiotic-Resistant Bacteria on the Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation: A Retrospective, Single-Center Study (CROSBI ID 234272)
Prilog u časopisu | izvorni znanstveni rad | međunarodna recenzija
Podaci o odgovornosti
Bilinski, Jaroslaw ; Robak, Katarzyna ; Perić, Zinaida ; Marchel, Halina ; Karakulska-Prystupiuk, Ewa ; Halaburda, Kazimierz ; Rusicka, Patrycja ; Swoboda-Kopec Ewa ; Wroblewska, Marta ; Wiktor-Jedrzejczak, Wieslaw ; Basak, Grzegorz W.
engleski
Impact of Gut Colonization by Antibiotic-Resistant Bacteria on the Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation: A Retrospective, Single-Center Study
Gut colonization by antibiotic-resistant bacteria may underlie hard-to-treat systemic infections. There is also accumulating evidence on the immunomodulatory function of gut microbiota after allogeneic stem cell transplantation (alloSCT) and its impact on graft-versus-host disease (GVHD). We investigated the epidemiology and clinical impact of gut colonization after alloSCT and retrospectively analyzed data on 107 alloSCTs performed at a single transplant center. Pretransplant microbiology screening identified colonization in 31% of cases. Colonization had a negative impact on overall survival after alloSCT in univariate (34% versus 74% at 24 months, P < .001) and multivariate (hazard ratio, 3.53 ; 95% confidence interval, 1.71 to 7.28 ; P < .001) analyses. Nonrelapse mortality was significantly higher in colonized than in noncolonized patients (42% versus 11% at 24 months, P = .001). Colonized patients more frequently experienced bacteremia (48% versus 24%, P = .01), and more deaths were attributable to infectious causes in the colonized group (42% versus 11% of patients and 67% versus 29% of deaths, P < .05). We observed a significantly higher incidence of grades II to IV acute GVHD in colonized than in noncolonized patients (42% versus 23%, P < .05), especially involving the gastrointestinal system (33% versus 13.5%, P = .07). In summary, we determined that gut colonization by antibiotic-resistant bacteria decreases the overall survival of patients undergoing alloSCT by increasing nonrelapse mortality and the incidences of systemic infection and acute GVHD.
Gut colonization ; Antibiotic-resistant bacteria ; Hematopoietic stem cell transplantation ; Bacteremia
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Podaci o izdanju
22 (6)
2016.
1087-1093
objavljeno
1083-8791
10.1016/j.bbmt.2016.02.009
Povezanost rada
Kliničke medicinske znanosti