Comparison of characteristics of bacterial bloodstream infection between adult patients with allogeneic and autologous hematopoietic stem cell transplantation

Junshik Hong, Song Mi Moon, Hee Kyung Ahn, Sun Jin Sym, Yoon Soo Park, Jinny Park, Yong Kyun Cho, Eun Kyung Cho, Dong Bok Shin, Jae Hoon Lee

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Although autologous and allogeneic hematopoietic stem cell transplantation (HSCT) are fundamentally different procedures, a tailored approach to bacterial bloodstream infection (BSI) according to the type of HSCT has not yet been suggested. We evaluated the characteristics of BSI after HSCT, with a focus on comparison of BSIs between recipients of autologous HSCT (auto-HSCT) and allogeneic HSCT (allo-HSCT). Among 134 patients (59 received allo-HSCT and 75 received auto-HSCT) who underwent HSCT, BSIs were reported earlier in patients who underwent auto-HSCT, compared with those who underwent allo-HSCT (mean 12.1 ± 3.4 days versus 32.8 ± 27.1 days, P = .006). Among patients receiving allo-HSCT, postneutrophil-engraftment bacterial BSI showed an association with grade ≥2 acute graft-versus-host disease (GVHD). In patients who underwent auto-HSCT, results of multivariate analysis showed that not receiving prophylactic antibiotics (. P = .004) and having elevated serum C-reactive protein (. P = .034) were risk factors of BSI. Elevated CRP (. P = .01) and acute GVHD ≥ grade 2 (. P = .002) were independent risk factors in patients who underwent allo-HSCT. Those differences originated mainly from the impact of acute GVHD-related postengraftment BSIs of patients who underwent allo-HSCT. To establish the best defense strategy against BSI, the distinctive natures of bacterial BSI after HSCT between auto-HSCT and allo-HSCT should be considered.

Original languageEnglish
Pages (from-to)994-999
Number of pages6
JournalBiology of Blood and Marrow Transplantation
Volume19
Issue number6
DOIs
StatePublished - 1 Jun 2013

Keywords

  • Antibiotic prophylaxis
  • Bacterial infection
  • Bloodstream infection
  • Hematopoietic stem cell transplantation

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