Non-viral pathogens of infectious diarrhoea post-allogeneic stem cell transplantation are associated with graft-versus-host disease
Infectious diarrhoea is common post-allogeneic haematopoietic stem-cell transplantation (alloHSCT). While the epidemiology of Clostridioides difficile infection (CDI) post-alloHSCT has been described, the impact of other diarrhoeal pathogens is uncertain. We reviewed all alloHSCT between 2017 and 20...
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| Veröffentlicht in: | Annals of hematology 2024-02, Vol.103 (2), p.593-602 |
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| creator | Rees, Matthew J. Rivalland, Alexandra Tan, Sarah Xie, Mingdi Yong, Michelle K. Ritchie, David |
| description | Infectious diarrhoea is common post-allogeneic haematopoietic stem-cell transplantation (alloHSCT). While the epidemiology of
Clostridioides difficile
infection (CDI) post-alloHSCT has been described, the impact of other diarrhoeal pathogens is uncertain. We reviewed all alloHSCT between 2017 and 2022 at a single large transplant centre; 374 patients were identified and included. The 1-year incidence of infectious diarrhoea was 23%, divided into viral (13/374, 3%), CDI (65/374, 17%) and other bacterial infections (16/374, 4%). There was a significant association between infectious diarrhoea within 1 year post-transplant and the occurrence of severe acute lower gastrointestinal graft-versus-host disease (GVHD, OR = 4.64, 95% CI 2.57–8.38,
p
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| doi_str_mv | 10.1007/s00277-023-05526-6 |
| format | Article |
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Clostridioides difficile
infection (CDI) post-alloHSCT has been described, the impact of other diarrhoeal pathogens is uncertain. We reviewed all alloHSCT between 2017 and 2022 at a single large transplant centre; 374 patients were identified and included. The 1-year incidence of infectious diarrhoea was 23%, divided into viral (13/374, 3%), CDI (65/374, 17%) and other bacterial infections (16/374, 4%). There was a significant association between infectious diarrhoea within 1 year post-transplant and the occurrence of severe acute lower gastrointestinal graft-versus-host disease (GVHD, OR = 4.64, 95% CI 2.57–8.38,
p
< 0.001) and inferior GVHD-free, relapse-free survival on analysis adjusted for age, donor type, stem cell source and T-cell depletion (aHR = 1.64, 95% CI = 1.18–2.27,
p
= 0.003). When the classes of infectious diarrhoea were compared to no infection, bacterial (OR = 6.38, 95% CI 1.90–21.40,
p
= 0.003), CDI (OR = 3.80, 95% CI 1.91–7.53,
p
< 0.001) and multiple infections (OR = 11.16, 95% CI 2.84–43.92,
p
< 0.001) were all independently associated with a higher risk of severe GI GVHD. Conversely, viral infections were not (OR = 2.98, 95% CI 0.57–15.43,
p
= 0.20). Non-viral infectious diarrhoea is significantly associated with the development of GVHD. Research to examine whether the prevention of infectious diarrhoea via infection control measures or modulation of the microbiome reduces the incidence of GVHD is needed.</description><identifier>ISSN: 0939-5555</identifier><identifier>EISSN: 1432-0584</identifier><identifier>DOI: 10.1007/s00277-023-05526-6</identifier><identifier>PMID: 37926752</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Bacterial infections ; Diarrhea ; Graft versus host disease ; Hematology ; Infections ; Medicine ; Medicine & Public Health ; Oncology ; Original Article ; Pathogens ; Stem cells ; Transplants & implants ; Viral infections</subject><ispartof>Annals of hematology, 2024-02, Vol.103 (2), p.593-602</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-ac24255fc7c5fc6505c54fcad9869c2dd40d6e2077c751e25ddb0912db2024363</cites><orcidid>0000-0001-8360-2952</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00277-023-05526-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00277-023-05526-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37926752$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rees, Matthew J.</creatorcontrib><creatorcontrib>Rivalland, Alexandra</creatorcontrib><creatorcontrib>Tan, Sarah</creatorcontrib><creatorcontrib>Xie, Mingdi</creatorcontrib><creatorcontrib>Yong, Michelle K.</creatorcontrib><creatorcontrib>Ritchie, David</creatorcontrib><title>Non-viral pathogens of infectious diarrhoea post-allogeneic stem cell transplantation are associated with graft-versus-host disease</title><title>Annals of hematology</title><addtitle>Ann Hematol</addtitle><addtitle>Ann Hematol</addtitle><description>Infectious diarrhoea is common post-allogeneic haematopoietic stem-cell transplantation (alloHSCT). While the epidemiology of
Clostridioides difficile
infection (CDI) post-alloHSCT has been described, the impact of other diarrhoeal pathogens is uncertain. We reviewed all alloHSCT between 2017 and 2022 at a single large transplant centre; 374 patients were identified and included. The 1-year incidence of infectious diarrhoea was 23%, divided into viral (13/374, 3%), CDI (65/374, 17%) and other bacterial infections (16/374, 4%). There was a significant association between infectious diarrhoea within 1 year post-transplant and the occurrence of severe acute lower gastrointestinal graft-versus-host disease (GVHD, OR = 4.64, 95% CI 2.57–8.38,
p
< 0.001) and inferior GVHD-free, relapse-free survival on analysis adjusted for age, donor type, stem cell source and T-cell depletion (aHR = 1.64, 95% CI = 1.18–2.27,
p
= 0.003). When the classes of infectious diarrhoea were compared to no infection, bacterial (OR = 6.38, 95% CI 1.90–21.40,
p
= 0.003), CDI (OR = 3.80, 95% CI 1.91–7.53,
p
< 0.001) and multiple infections (OR = 11.16, 95% CI 2.84–43.92,
p
< 0.001) were all independently associated with a higher risk of severe GI GVHD. Conversely, viral infections were not (OR = 2.98, 95% CI 0.57–15.43,
p
= 0.20). Non-viral infectious diarrhoea is significantly associated with the development of GVHD. Research to examine whether the prevention of infectious diarrhoea via infection control measures or modulation of the microbiome reduces the incidence of GVHD is needed.</description><subject>Bacterial infections</subject><subject>Diarrhea</subject><subject>Graft versus host disease</subject><subject>Hematology</subject><subject>Infections</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Pathogens</subject><subject>Stem cells</subject><subject>Transplants & implants</subject><subject>Viral infections</subject><issn>0939-5555</issn><issn>1432-0584</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kU9v1DAQxS1ERZfCF-CALHHhYuqMYzs5ooo_lSq4wNny2pPdVNk4eJyinvnieNkCEgd8GMua37x51mPsRSPfNFLaS5ISrBUSlJBagxHmEds0rYL67NrHbCN71Qtdzzl7SnQrZQNdC0_YubI9GKthw358SrO4G7Of-OLLPu1wJp4GPs4DhjKmlXgcfc77hJ4viYrw03SkcAycCh54wGniJfuZlsnPxdehmfuM3BOlMPqCkX8fy57vsh-KuMNMK4l9larKhJ7wGTsb_ET4_OG-YF_fv_ty9VHcfP5wffX2RgQFpi4O0ILWQ7ChFqOlDrodgo99Z_oAMbYyGgRpbbC6QdAxbmXfQNyChFYZdcFen3SXnL6tSMUdRjra9zPWjzroOmNkY7Sq6Kt_0Nu05rm6c9BXojG9kZWCExVyIso4uCWPB5_vXSPdMSJ3isjViNyviNzRxcsH6XV7wPhn5HcmFVAngGpr3mH-u_s_sj8B-UyekA</recordid><startdate>20240201</startdate><enddate>20240201</enddate><creator>Rees, Matthew J.</creator><creator>Rivalland, Alexandra</creator><creator>Tan, Sarah</creator><creator>Xie, Mingdi</creator><creator>Yong, Michelle K.</creator><creator>Ritchie, David</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8360-2952</orcidid></search><sort><creationdate>20240201</creationdate><title>Non-viral pathogens of infectious diarrhoea post-allogeneic stem cell transplantation are associated with graft-versus-host disease</title><author>Rees, Matthew J. ; Rivalland, Alexandra ; Tan, Sarah ; Xie, Mingdi ; Yong, Michelle K. ; Ritchie, David</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-ac24255fc7c5fc6505c54fcad9869c2dd40d6e2077c751e25ddb0912db2024363</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Bacterial infections</topic><topic>Diarrhea</topic><topic>Graft versus host disease</topic><topic>Hematology</topic><topic>Infections</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Pathogens</topic><topic>Stem cells</topic><topic>Transplants & implants</topic><topic>Viral infections</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rees, Matthew J.</creatorcontrib><creatorcontrib>Rivalland, Alexandra</creatorcontrib><creatorcontrib>Tan, Sarah</creatorcontrib><creatorcontrib>Xie, Mingdi</creatorcontrib><creatorcontrib>Yong, Michelle K.</creatorcontrib><creatorcontrib>Ritchie, David</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</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>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 Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</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>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of hematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rees, Matthew J.</au><au>Rivalland, Alexandra</au><au>Tan, Sarah</au><au>Xie, Mingdi</au><au>Yong, Michelle K.</au><au>Ritchie, David</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Non-viral pathogens of infectious diarrhoea post-allogeneic stem cell transplantation are associated with graft-versus-host disease</atitle><jtitle>Annals of hematology</jtitle><stitle>Ann Hematol</stitle><addtitle>Ann Hematol</addtitle><date>2024-02-01</date><risdate>2024</risdate><volume>103</volume><issue>2</issue><spage>593</spage><epage>602</epage><pages>593-602</pages><issn>0939-5555</issn><eissn>1432-0584</eissn><abstract>Infectious diarrhoea is common post-allogeneic haematopoietic stem-cell transplantation (alloHSCT). While the epidemiology of
Clostridioides difficile
infection (CDI) post-alloHSCT has been described, the impact of other diarrhoeal pathogens is uncertain. We reviewed all alloHSCT between 2017 and 2022 at a single large transplant centre; 374 patients were identified and included. The 1-year incidence of infectious diarrhoea was 23%, divided into viral (13/374, 3%), CDI (65/374, 17%) and other bacterial infections (16/374, 4%). There was a significant association between infectious diarrhoea within 1 year post-transplant and the occurrence of severe acute lower gastrointestinal graft-versus-host disease (GVHD, OR = 4.64, 95% CI 2.57–8.38,
p
< 0.001) and inferior GVHD-free, relapse-free survival on analysis adjusted for age, donor type, stem cell source and T-cell depletion (aHR = 1.64, 95% CI = 1.18–2.27,
p
= 0.003). When the classes of infectious diarrhoea were compared to no infection, bacterial (OR = 6.38, 95% CI 1.90–21.40,
p
= 0.003), CDI (OR = 3.80, 95% CI 1.91–7.53,
p
< 0.001) and multiple infections (OR = 11.16, 95% CI 2.84–43.92,
p
< 0.001) were all independently associated with a higher risk of severe GI GVHD. Conversely, viral infections were not (OR = 2.98, 95% CI 0.57–15.43,
p
= 0.20). Non-viral infectious diarrhoea is significantly associated with the development of GVHD. Research to examine whether the prevention of infectious diarrhoea via infection control measures or modulation of the microbiome reduces the incidence of GVHD is needed.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>37926752</pmid><doi>10.1007/s00277-023-05526-6</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-8360-2952</orcidid></addata></record> |
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| source | Springer Nature - Complete Springer Journals |
| subjects | Bacterial infections Diarrhea Graft versus host disease Hematology Infections Medicine Medicine & Public Health Oncology Original Article Pathogens Stem cells Transplants & implants Viral infections |
| title | Non-viral pathogens of infectious diarrhoea post-allogeneic stem cell transplantation are associated with graft-versus-host disease |
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