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Multidrug‐resistant organisms in allogeneic hematopoietic cell transplantation
Author(s) -
Heidenreich Daniela,
Kreil Sebastian,
Nolte Florian,
Hofmann Wolf K.,
Miethke Thomas,
Klein Stefan A.
Publication year - 2017
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12859
Subject(s) - medicine , transplantation , hematopoietic stem cell transplantation , hematopoietic cell , pseudomonas aeruginosa , single center , retrospective cohort study , medical record , multiple drug resistance , haematopoiesis , drug resistance , stem cell , biology , bacteria , microbiology and biotechnology , genetics
Objective Multidrug‐resistant organisms (MDRO) are a challenge in allogeneic hematopoietic cell transplantation (HCT). However, in the literature there is no comprehensive analysis on MDRO in HCT. In this retrospective, single‐center analysis, we appraised prevalence and clinical impact of MDRO in 98 consecutive allogeneic HCT patients. Method Prior to the conditioning (baseline) and whenever clinically indicated patients underwent a full screening for MDRO (stool and urine cultures, swabs from several body regions). Results It turned out that 26 patients were colonized by 33 MDRO, either at baseline (n=16) or at any other time until day 100 post‐transplantation. Of these 26 patients, eight developed an infection with MDRO, four of them by 4MRGN Pseudomonas aeruginosa , and three of them died MDRO‐related. However, there was no significant difference between MDRO‐colonized and non‐colonized patients regarding overall survival (OS) and non‐relapse‐mortality (NRM). There was only a trend toward a higher NRM in patients already colonized by MDRO at baseline. This was due to the high NRM in multidrug‐resistant P. aeruginosa ‐colonized patients. Conclusion In summary, colonization with MDRO other than P. aeruginosa had no negative impact on NRM and OS. Patients colonized by multidrug‐resistant P. aeruginosa had a dismal outcome. HCT of these patients should be considered with care. Screening for MDRO in the pretransplant work‐up is suggested.