Mortality after bloodstream infections in allogeneic haematopoietic stem cell transplant (HSCT) recipients
Purpose Bloodstream infections (BSIs) are frequent after allogeneic haematopoietic stem cell transplantation (HSCT). The aim of this study was to identify predictors of mortality after BSI in patients who undergo HSCT. Methods Patients who underwent HSCT between 1 January 2004 and 31 January 2008 an...
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| Veröffentlicht in: | Infection 2012-06, Vol.40 (3), p.271-278 |
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| creator | Mikulska, M. Del Bono, V. Bruzzi, P. Raiola, A. M. Gualandi, F. Van Lint, M. T. Bacigalupo, A. Viscoli, C. |
| description | Purpose
Bloodstream infections (BSIs) are frequent after allogeneic haematopoietic stem cell transplantation (HSCT). The aim of this study was to identify predictors of mortality after BSI in patients who undergo HSCT.
Methods
Patients who underwent HSCT between 1 January 2004 and 31 January 2008 and developed BSI during the first year post-transplantation were included. Variables influencing overall mortality at 7 and 30 days after BSI were analysed.
Results
BSIs developed in 149 patients, within a median of 9 days after undergoing HSCT. Early and late mortality were 15 and 27%, respectively. Of the BSI, 54% were due to Gram-positive microorganisms, 33% were due to Gram-negative microogranisms, 10% were polymicrobial and 3% were fungal. The associated 7-and 30-day mortality was respectively 10 and 24% (Gram positive), 22 and 31% (Gram negative;
Pseudomonas aeruginosa
mortality 67%, all within 7 days), 13 and 27% (polymicrobial) and 40% (fungal, all within 7 days). Early mortality was higher in relapsed disease at HSCT (25.9%,
p
= 0.01), but lower in early (i.e. within 20 days of HSCT) BSI (11.7%,
p
= 0.03) and BSI due to Gram-positive infective agents (10%,
p
= 0.05). Multivariate analysis confirmed a higher mortality in late BSI [odds ratio (OR) 3.29,
p
= 0.03] and relapsed disease at HSCT (OR 2.2,
p
= 0.04). Late mortality was associated with the type of underlying disease (OR 0.44 for diseases other than acute leukaemia,
p
= 0.05) and its status (OR 6.04 for relapse at HSCT,
p
= 0.001). Appropriate empirical therapy was associated with lower early and late mortality in single Gram-negative BSI (16 vs. 45% for 7-day mortality,
p
= 0.09; 21 vs. 64% for 30-day mortality,
p
= 0.02).
Conclusions
BSIs are frequent during the first year after HSCT and are associated with a high mortality rate. The aetiology influenced early mortality, while the type and phase of the underlying disease played a pivotal role in late mortality. Appropriate empirical therapy is crucial in BSI due to Gram-negative infective agents. |
| doi_str_mv | 10.1007/s15010-011-0229-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1022842987</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2698884761</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-a2163c0854eaa7c3d19799ca0173c030e1ea101c06f024aa8566a0605bc441683</originalsourceid><addsrcrecordid>eNp1kU1vEzEQhi0EomnKD-CCLHFpDwsz9n4eUdQvqYgD7Xk1cWaLo117sZ1D_n0dUipUiZPt8TPvjN5XiI8IXxCg-RqxAoQCEAtQqiv2b8QCS90V0DX6rViABihaVPWJOI1xCwBVVzbvxYlS2Da6hIXYfvch0WjTXtKQOMj16P0mpsA0SesGNsl6F_NV0jj6R3ZsjfxFPFHys7ec8jMmnqThcZQpkIvzSC7J85ufq_sLGdjY2bJL8Uy8G2iM_OH5XIqHq8v71U1x9-P6dvXtrjC6UakghbU20FYlEzVGb7Brus4QYJPLGhiZENBAPYAqidqqrglqqNamLLFu9VKcH3Xn4H_vOKZ-svGwHTn2u9hj9qotVZcdWIrPr9Ct3wWXt_tDVRXmSZnCI2WCjzHw0M_BThT2GeoPQfTHIPocRH8Iot_nnk_Pyrv1xJuXjr_OZ0AdgZi_3COHf0f_T_UJHRaTTA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1022551101</pqid></control><display><type>article</type><title>Mortality after bloodstream infections in allogeneic haematopoietic stem cell transplant (HSCT) recipients</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Mikulska, M. ; Del Bono, V. ; Bruzzi, P. ; Raiola, A. M. ; Gualandi, F. ; Van Lint, M. T. ; Bacigalupo, A. ; Viscoli, C.</creator><creatorcontrib>Mikulska, M. ; Del Bono, V. ; Bruzzi, P. ; Raiola, A. M. ; Gualandi, F. ; Van Lint, M. T. ; Bacigalupo, A. ; Viscoli, C.</creatorcontrib><description>Purpose
Bloodstream infections (BSIs) are frequent after allogeneic haematopoietic stem cell transplantation (HSCT). The aim of this study was to identify predictors of mortality after BSI in patients who undergo HSCT.
Methods
Patients who underwent HSCT between 1 January 2004 and 31 January 2008 and developed BSI during the first year post-transplantation were included. Variables influencing overall mortality at 7 and 30 days after BSI were analysed.
Results
BSIs developed in 149 patients, within a median of 9 days after undergoing HSCT. Early and late mortality were 15 and 27%, respectively. Of the BSI, 54% were due to Gram-positive microorganisms, 33% were due to Gram-negative microogranisms, 10% were polymicrobial and 3% were fungal. The associated 7-and 30-day mortality was respectively 10 and 24% (Gram positive), 22 and 31% (Gram negative;
Pseudomonas aeruginosa
mortality 67%, all within 7 days), 13 and 27% (polymicrobial) and 40% (fungal, all within 7 days). Early mortality was higher in relapsed disease at HSCT (25.9%,
p
= 0.01), but lower in early (i.e. within 20 days of HSCT) BSI (11.7%,
p
= 0.03) and BSI due to Gram-positive infective agents (10%,
p
= 0.05). Multivariate analysis confirmed a higher mortality in late BSI [odds ratio (OR) 3.29,
p
= 0.03] and relapsed disease at HSCT (OR 2.2,
p
= 0.04). Late mortality was associated with the type of underlying disease (OR 0.44 for diseases other than acute leukaemia,
p
= 0.05) and its status (OR 6.04 for relapse at HSCT,
p
= 0.001). Appropriate empirical therapy was associated with lower early and late mortality in single Gram-negative BSI (16 vs. 45% for 7-day mortality,
p
= 0.09; 21 vs. 64% for 30-day mortality,
p
= 0.02).
Conclusions
BSIs are frequent during the first year after HSCT and are associated with a high mortality rate. The aetiology influenced early mortality, while the type and phase of the underlying disease played a pivotal role in late mortality. Appropriate empirical therapy is crucial in BSI due to Gram-negative infective agents.</description><identifier>ISSN: 0300-8126</identifier><identifier>EISSN: 1439-0973</identifier><identifier>DOI: 10.1007/s15010-011-0229-y</identifier><identifier>PMID: 22187340</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Adolescent ; Adult ; Aged ; Bacteremia - epidemiology ; Bacteremia - microbiology ; Bacteremia - mortality ; Bacteria - isolation & purification ; Clinical and Epidemiological Study ; Cohort Studies ; Coinfection - epidemiology ; Coinfection - microbiology ; Coinfection - mortality ; Family Medicine ; Female ; Fungemia - epidemiology ; Fungemia - microbiology ; Fungemia - mortality ; Fungi - isolation & purification ; General Practice ; Hematopoietic Stem Cell Transplantation - adverse effects ; Hematopoietic Stem Cell Transplantation - mortality ; Hematopoietic Stem Cell Transplantation - statistics & numerical data ; Humans ; Infectious Diseases ; Internal Medicine ; Italy ; Leukemia ; Male ; Medicine ; Medicine & Public Health ; Microorganisms ; Middle Aged ; Mortality ; Multivariate Analysis ; Odds Ratio ; Retrospective Studies ; Risk Factors ; Stem cells ; Survival Analysis ; Time Factors ; Transplantation, Homologous - adverse effects ; Transplantation, Homologous - mortality ; Transplantation, Homologous - statistics & numerical data ; Young Adult</subject><ispartof>Infection, 2012-06, Vol.40 (3), p.271-278</ispartof><rights>Springer-Verlag 2011</rights><rights>Springer-Verlag 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-a2163c0854eaa7c3d19799ca0173c030e1ea101c06f024aa8566a0605bc441683</citedby><cites>FETCH-LOGICAL-c372t-a2163c0854eaa7c3d19799ca0173c030e1ea101c06f024aa8566a0605bc441683</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s15010-011-0229-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s15010-011-0229-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22187340$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mikulska, M.</creatorcontrib><creatorcontrib>Del Bono, V.</creatorcontrib><creatorcontrib>Bruzzi, P.</creatorcontrib><creatorcontrib>Raiola, A. M.</creatorcontrib><creatorcontrib>Gualandi, F.</creatorcontrib><creatorcontrib>Van Lint, M. T.</creatorcontrib><creatorcontrib>Bacigalupo, A.</creatorcontrib><creatorcontrib>Viscoli, C.</creatorcontrib><title>Mortality after bloodstream infections in allogeneic haematopoietic stem cell transplant (HSCT) recipients</title><title>Infection</title><addtitle>Infection</addtitle><addtitle>Infection</addtitle><description>Purpose
Bloodstream infections (BSIs) are frequent after allogeneic haematopoietic stem cell transplantation (HSCT). The aim of this study was to identify predictors of mortality after BSI in patients who undergo HSCT.
Methods
Patients who underwent HSCT between 1 January 2004 and 31 January 2008 and developed BSI during the first year post-transplantation were included. Variables influencing overall mortality at 7 and 30 days after BSI were analysed.
Results
BSIs developed in 149 patients, within a median of 9 days after undergoing HSCT. Early and late mortality were 15 and 27%, respectively. Of the BSI, 54% were due to Gram-positive microorganisms, 33% were due to Gram-negative microogranisms, 10% were polymicrobial and 3% were fungal. The associated 7-and 30-day mortality was respectively 10 and 24% (Gram positive), 22 and 31% (Gram negative;
Pseudomonas aeruginosa
mortality 67%, all within 7 days), 13 and 27% (polymicrobial) and 40% (fungal, all within 7 days). Early mortality was higher in relapsed disease at HSCT (25.9%,
p
= 0.01), but lower in early (i.e. within 20 days of HSCT) BSI (11.7%,
p
= 0.03) and BSI due to Gram-positive infective agents (10%,
p
= 0.05). Multivariate analysis confirmed a higher mortality in late BSI [odds ratio (OR) 3.29,
p
= 0.03] and relapsed disease at HSCT (OR 2.2,
p
= 0.04). Late mortality was associated with the type of underlying disease (OR 0.44 for diseases other than acute leukaemia,
p
= 0.05) and its status (OR 6.04 for relapse at HSCT,
p
= 0.001). Appropriate empirical therapy was associated with lower early and late mortality in single Gram-negative BSI (16 vs. 45% for 7-day mortality,
p
= 0.09; 21 vs. 64% for 30-day mortality,
p
= 0.02).
Conclusions
BSIs are frequent during the first year after HSCT and are associated with a high mortality rate. The aetiology influenced early mortality, while the type and phase of the underlying disease played a pivotal role in late mortality. Appropriate empirical therapy is crucial in BSI due to Gram-negative infective agents.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Bacteremia - epidemiology</subject><subject>Bacteremia - microbiology</subject><subject>Bacteremia - mortality</subject><subject>Bacteria - isolation & purification</subject><subject>Clinical and Epidemiological Study</subject><subject>Cohort Studies</subject><subject>Coinfection - epidemiology</subject><subject>Coinfection - microbiology</subject><subject>Coinfection - mortality</subject><subject>Family Medicine</subject><subject>Female</subject><subject>Fungemia - epidemiology</subject><subject>Fungemia - microbiology</subject><subject>Fungemia - mortality</subject><subject>Fungi - isolation & purification</subject><subject>General Practice</subject><subject>Hematopoietic Stem Cell Transplantation - adverse effects</subject><subject>Hematopoietic Stem Cell Transplantation - mortality</subject><subject>Hematopoietic Stem Cell Transplantation - statistics & numerical data</subject><subject>Humans</subject><subject>Infectious Diseases</subject><subject>Internal Medicine</subject><subject>Italy</subject><subject>Leukemia</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Microorganisms</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate Analysis</subject><subject>Odds Ratio</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Stem cells</subject><subject>Survival Analysis</subject><subject>Time Factors</subject><subject>Transplantation, Homologous - adverse effects</subject><subject>Transplantation, Homologous - mortality</subject><subject>Transplantation, Homologous - statistics & numerical data</subject><subject>Young Adult</subject><issn>0300-8126</issn><issn>1439-0973</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU1vEzEQhi0EomnKD-CCLHFpDwsz9n4eUdQvqYgD7Xk1cWaLo117sZ1D_n0dUipUiZPt8TPvjN5XiI8IXxCg-RqxAoQCEAtQqiv2b8QCS90V0DX6rViABihaVPWJOI1xCwBVVzbvxYlS2Da6hIXYfvch0WjTXtKQOMj16P0mpsA0SesGNsl6F_NV0jj6R3ZsjfxFPFHys7ec8jMmnqThcZQpkIvzSC7J85ufq_sLGdjY2bJL8Uy8G2iM_OH5XIqHq8v71U1x9-P6dvXtrjC6UakghbU20FYlEzVGb7Brus4QYJPLGhiZENBAPYAqidqqrglqqNamLLFu9VKcH3Xn4H_vOKZ-svGwHTn2u9hj9qotVZcdWIrPr9Ct3wWXt_tDVRXmSZnCI2WCjzHw0M_BThT2GeoPQfTHIPocRH8Iot_nnk_Pyrv1xJuXjr_OZ0AdgZi_3COHf0f_T_UJHRaTTA</recordid><startdate>20120601</startdate><enddate>20120601</enddate><creator>Mikulska, M.</creator><creator>Del Bono, V.</creator><creator>Bruzzi, P.</creator><creator>Raiola, A. M.</creator><creator>Gualandi, F.</creator><creator>Van Lint, M. T.</creator><creator>Bacigalupo, A.</creator><creator>Viscoli, C.</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>20120601</creationdate><title>Mortality after bloodstream infections in allogeneic haematopoietic stem cell transplant (HSCT) recipients</title><author>Mikulska, M. ; Del Bono, V. ; Bruzzi, P. ; Raiola, A. M. ; Gualandi, F. ; Van Lint, M. T. ; Bacigalupo, A. ; Viscoli, C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-a2163c0854eaa7c3d19799ca0173c030e1ea101c06f024aa8566a0605bc441683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Bacteremia - epidemiology</topic><topic>Bacteremia - microbiology</topic><topic>Bacteremia - mortality</topic><topic>Bacteria - isolation & purification</topic><topic>Clinical and Epidemiological Study</topic><topic>Cohort Studies</topic><topic>Coinfection - epidemiology</topic><topic>Coinfection - microbiology</topic><topic>Coinfection - mortality</topic><topic>Family Medicine</topic><topic>Female</topic><topic>Fungemia - epidemiology</topic><topic>Fungemia - microbiology</topic><topic>Fungemia - mortality</topic><topic>Fungi - isolation & purification</topic><topic>General Practice</topic><topic>Hematopoietic Stem Cell Transplantation - adverse effects</topic><topic>Hematopoietic Stem Cell Transplantation - mortality</topic><topic>Hematopoietic Stem Cell Transplantation - statistics & numerical data</topic><topic>Humans</topic><topic>Infectious Diseases</topic><topic>Internal Medicine</topic><topic>Italy</topic><topic>Leukemia</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Microorganisms</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate Analysis</topic><topic>Odds Ratio</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Stem cells</topic><topic>Survival Analysis</topic><topic>Time Factors</topic><topic>Transplantation, Homologous - adverse effects</topic><topic>Transplantation, Homologous - mortality</topic><topic>Transplantation, Homologous - statistics & numerical data</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mikulska, M.</creatorcontrib><creatorcontrib>Del Bono, V.</creatorcontrib><creatorcontrib>Bruzzi, P.</creatorcontrib><creatorcontrib>Raiola, A. M.</creatorcontrib><creatorcontrib>Gualandi, F.</creatorcontrib><creatorcontrib>Van Lint, M. T.</creatorcontrib><creatorcontrib>Bacigalupo, A.</creatorcontrib><creatorcontrib>Viscoli, C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Infection</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mikulska, M.</au><au>Del Bono, V.</au><au>Bruzzi, P.</au><au>Raiola, A. M.</au><au>Gualandi, F.</au><au>Van Lint, M. T.</au><au>Bacigalupo, A.</au><au>Viscoli, C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mortality after bloodstream infections in allogeneic haematopoietic stem cell transplant (HSCT) recipients</atitle><jtitle>Infection</jtitle><stitle>Infection</stitle><addtitle>Infection</addtitle><date>2012-06-01</date><risdate>2012</risdate><volume>40</volume><issue>3</issue><spage>271</spage><epage>278</epage><pages>271-278</pages><issn>0300-8126</issn><eissn>1439-0973</eissn><abstract>Purpose
Bloodstream infections (BSIs) are frequent after allogeneic haematopoietic stem cell transplantation (HSCT). The aim of this study was to identify predictors of mortality after BSI in patients who undergo HSCT.
Methods
Patients who underwent HSCT between 1 January 2004 and 31 January 2008 and developed BSI during the first year post-transplantation were included. Variables influencing overall mortality at 7 and 30 days after BSI were analysed.
Results
BSIs developed in 149 patients, within a median of 9 days after undergoing HSCT. Early and late mortality were 15 and 27%, respectively. Of the BSI, 54% were due to Gram-positive microorganisms, 33% were due to Gram-negative microogranisms, 10% were polymicrobial and 3% were fungal. The associated 7-and 30-day mortality was respectively 10 and 24% (Gram positive), 22 and 31% (Gram negative;
Pseudomonas aeruginosa
mortality 67%, all within 7 days), 13 and 27% (polymicrobial) and 40% (fungal, all within 7 days). Early mortality was higher in relapsed disease at HSCT (25.9%,
p
= 0.01), but lower in early (i.e. within 20 days of HSCT) BSI (11.7%,
p
= 0.03) and BSI due to Gram-positive infective agents (10%,
p
= 0.05). Multivariate analysis confirmed a higher mortality in late BSI [odds ratio (OR) 3.29,
p
= 0.03] and relapsed disease at HSCT (OR 2.2,
p
= 0.04). Late mortality was associated with the type of underlying disease (OR 0.44 for diseases other than acute leukaemia,
p
= 0.05) and its status (OR 6.04 for relapse at HSCT,
p
= 0.001). Appropriate empirical therapy was associated with lower early and late mortality in single Gram-negative BSI (16 vs. 45% for 7-day mortality,
p
= 0.09; 21 vs. 64% for 30-day mortality,
p
= 0.02).
Conclusions
BSIs are frequent during the first year after HSCT and are associated with a high mortality rate. The aetiology influenced early mortality, while the type and phase of the underlying disease played a pivotal role in late mortality. Appropriate empirical therapy is crucial in BSI due to Gram-negative infective agents.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>22187340</pmid><doi>10.1007/s15010-011-0229-y</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Infection, 2012-06, Vol.40 (3), p.271-278 |
| issn | 0300-8126 1439-0973 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1022842987 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adolescent Adult Aged Bacteremia - epidemiology Bacteremia - microbiology Bacteremia - mortality Bacteria - isolation & purification Clinical and Epidemiological Study Cohort Studies Coinfection - epidemiology Coinfection - microbiology Coinfection - mortality Family Medicine Female Fungemia - epidemiology Fungemia - microbiology Fungemia - mortality Fungi - isolation & purification General Practice Hematopoietic Stem Cell Transplantation - adverse effects Hematopoietic Stem Cell Transplantation - mortality Hematopoietic Stem Cell Transplantation - statistics & numerical data Humans Infectious Diseases Internal Medicine Italy Leukemia Male Medicine Medicine & Public Health Microorganisms Middle Aged Mortality Multivariate Analysis Odds Ratio Retrospective Studies Risk Factors Stem cells Survival Analysis Time Factors Transplantation, Homologous - adverse effects Transplantation, Homologous - mortality Transplantation, Homologous - statistics & numerical data Young Adult |
| title | Mortality after bloodstream infections in allogeneic haematopoietic stem cell transplant (HSCT) recipients |
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