Risk factors for enterococcal bacteremia in allogeneic hematopoietic stem cell transplant recipients

Página do item simplificado
dc.contributor.authorMikulska, Malgorzata
dc.contributor.authorDel Bono, V.
dc.contributor.authorPrinapori, R.
dc.contributor.authorBoni, L.
dc.contributor.authorRaiola, A. M.
dc.contributor.authorGualandi, F.
dc.contributor.authorVan Lint, Maria Teresa
dc.contributor.authorDominietto, A.
dc.contributor.authorLamparelli, T.
dc.contributor.authorCappellano, Paola [UNIFESP]
dc.contributor.authorBacigalupo, Andrea
dc.contributor.authorViscoli, Claudio
dc.contributor.institutionSan Martino Univ Hosp
dc.contributor.institutionIst Toscano AOU Tumori Careggi
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T14:05:47Z
dc.date.available2016-01-24T14:05:47Z
dc.date.issued2010-12-01
dc.description.abstractP>Bacteremia is a well known cause of morbidity and mortality in hematopoietic stem cell transplant (HSCT) recipients and enterococci are among the most frequently isolated pathogens. the aim of this study was to identify risk factors for enterococcal bacteremia during the first 30 days after allogeneic HSCT. A retrospective case-control study was performed; for each case, 3 controls were randomly selected among 306 patients transplanted during the study period (January 1, 2004 to December 31, 2007). Odds ratios (OR) with 95% confidence intervals (CI) were calculated for variables influencing the risk for bacteremia. Overall, 33 patients developed enterococcal bacteremia, within a median of 9 days after HSCT (range, 2-24). the cumulative incidence was 10.8%. Multivariate analysis identified the following variables as risk factors for enterococcal bacteremia: donor and transplant type (greater risk for mismatched related or cord blood) (OR=8.98, 95% CI, 1.65-48.99 and OR=7.52, 95% CI, 1.56-36.31, respectively, P=0.047); severe (grades 3-4) mucositis (OR=9.04, 95% CI, 1.97-41.52, P=0.018); pharyngeal enterococcal colonization (OR=4.48, 95% CI, 1.11-18.03, P=0.035); and previous empirical therapy with cephalosporins (OR=4.16, 95% CI, 0.93-18.66 for 1-7 days of therapy, and OR=7.31, 95% CI, 1.78-30.12 for 8-23 days, P=0.018). Higher Karnofsky score (>= 50) and previous empirical therapy with glycopeptides were associated with a decreased risk (OR=0.25, 95% CI, 0.06-0.97, P=0.045 and OR=0.11, 95% CI, 0.02-0.59, P=0.010, respectively). the crude mortality at 7 and 30 days was 12% (4/33) and 24% (8/33), respectively. Enterococcal bacteremia is frequent after allogeneic HSCT. the factors associated with this infection are type of transplant, pharyngeal colonization, severe mucositis, and use of cephalosporins. Good general conditions and the use of vancomycin were associated with lower risk of enterococcal bacteremia.en
dc.description.affiliationSan Martino Univ Hosp, Div Infect Dis, I-16132 Genoa, Italy
dc.description.affiliationIst Toscano AOU Tumori Careggi, Clin Trials Coordinating Ctr, Florence, Italy
dc.description.affiliationSan Martino Univ Hosp, Div Haematol, Genoa, Italy
dc.description.affiliationSan Martino Univ Hosp, HSCT, Genoa, Italy
dc.description.affiliationUniversidade Federal de São Paulo, Div Infect Dis, Dept Med, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Div Infect Dis, Dept Med, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent505-512
dc.identifierhttp://dx.doi.org/10.1111/j.1399-3062.2010.00544.x
dc.identifier.citationTransplant Infectious Disease. Malden: Wiley-Blackwell Publishing, Inc, v. 12, n. 6, p. 505-512, 2010.
dc.identifier.doi10.1111/j.1399-3062.2010.00544.x
dc.identifier.issn1398-2273
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/33155
dc.identifier.wosWOS:000284902900005
dc.language.isoeng
dc.publisherWiley-Blackwell
dc.relation.ispartofTransplant Infectious Disease
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.rights.licensehttp://olabout.wiley.com/WileyCDA/Section/id-406071.html
dc.subjectEnterococcusen
dc.subjectBacteremiaen
dc.subjectSepsisen
dc.subjectAllogeneic transplanten
dc.subjectHSCTen
dc.subjectColonizationen
dc.subjectMucositisen
dc.subjectCephalosporinsen
dc.subjectVancomycinen
dc.titleRisk factors for enterococcal bacteremia in allogeneic hematopoietic stem cell transplant recipientsen
dc.typeinfo:eu-repo/semantics/article
Arquivos
Coleções
EPM - Artigos