کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
8429753 | 1546226 | 2018 | 30 صفحه PDF | دانلود رایگان |
عنوان انگلیسی مقاله ISI
Clinical Impact of Pretransplant Multidrug-Resistant Gram-Negative Colonization in Autologous and Allogeneic Hematopoietic Stem Cell Transplantation
ترجمه فارسی عنوان
اثرات بالینی چندوجهی کلونیزاسیون گرام منفی مقاوم به چندین دارو در سلول های بنیادی اتولوگ و آلوژنیک هماتوپوئیت
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کلمات کلیدی
موضوعات مرتبط
علوم زیستی و بیوفناوری
بیوشیمی، ژنتیک و زیست شناسی مولکولی
تحقیقات سرطان
چکیده انگلیسی
Multidrug-resistant Gram-negative bacteria (MDR-GNB) are an emerging cause of morbidity and mortality after hematopoietic stem cell transplantation (HSCT). Three-hundred forty-eight consecutive patients transplanted at our hospital from July 2012 to January 2016 were screened for a pretransplant MDR-GNB colonization and evaluated for clinical outcomes. A pretransplant MDR-GNB colonization was found in 16.9% of allo-HSCT and in 9.6% of auto-HSCT recipients. Both in auto- and in allo-HSCT, carriers of a MDR-GNB showed no significant differences in overall survival (OS), transplant-related mortality (TRM), or infection-related mortality (IRM) compared with noncarriers. OS at 2 years for carriers compared with noncarriers was 85% versus 81% (Pâ=â.262) in auto-HSCT and 50% versus 43% (Pâ=â.091) in allo-HSCT. TRM at 2 years was 14% versus 5% (Pâ=â.405) in auto-HSCT and 31% versus 25% (Pâ=â.301) in allo-HSCT. IRM at 2 years was 14% versus 2% (Pâ=â.142) in auto-HSCT and 23% versus 14% (Pâ=â.304) in allo-HSCT. In multivariate analysis, only grade III to IV acute graft-versus-host disease was an independent factor for reduced OS (Pâ<â.001) and increased TRM (Pâ<â.001) and IRM (Pâ<â.001). During the first year after transplant, we collected 73 GNB bloodstream infectious (BSI) episodes in 54 patients, 42.4% of which sustained by a MDR-GNB. Rectal swabs positivity associated with the pathogen causing subsequent MDR-GNB BSI episodes in 13 of 31 (41.9%). Overall, OS at 4 months from MDR-GNB BSI episode onset was of 67.9%, with a 14-day attributed mortality of 12.9%, not being significantly different between carriers and noncarriers (Pâ=â.207). We conclude that in this extended single-center experience, a pretransplant MDR-GNB colonization did not significantly influence OS, TRM, and IRM both in auto- and allo-HSCT settings and that MDR-GNB attributed mortality can be controlled in carriers when an early pre-emptive antimicrobial therapy is started in case of neutropenic fever.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Biology of Blood and Marrow Transplantation - Volume 24, Issue 7, July 2018, Pages 1476-1482
Journal: Biology of Blood and Marrow Transplantation - Volume 24, Issue 7, July 2018, Pages 1476-1482
نویسندگان
Alessandra Forcina, Francesca Lorentino, Vincenzo Marasco, Chiara Oltolini, Magda Marcatti, Raffaella Greco, Maria Teresa Lupo-Stanghellini, Matteo Carrabba, Massimo Bernardi, Jacopo Peccatori, Consuelo Corti, Fabio Ciceri,