[Altered gut bacterial flora and organic acids in feces of patients undergoing autologous stem cell transplantation with quinolone-based antibacterial prophylaxis].
Gastrointestinal toxicity and various infections are serious problems associated with high-dose chemotherapy. Antibacterial chemoprophylaxis reduces the incidence of gram-negative bacterial infection; however, it may affect the normal intestinal flora and induce drug resistance in organisms. We evaluated the chronological changes in fecal bacteria and organic acids in 6 patients undergoing autologous stem cell transplantation with quinolone-based chemoprophylaxis. All patients developed grade 2-3 diarrhea. Four patients developed grade 3 febrile neutropenia. The total count of obligatory anaerobic bacteria was significantly decreased on Day 7, but total facultative anaerobic bacterial count did not change throughout transplantation. However, Enterobacteriaceae and Lactobacillus were decreased on Day 7 and Staphylococcus was increased after transplantation. Total organic acid concentration and short-chain fatty acids were decreased on Day 7. The bacterial flora and organic acids in the gut were significantly altered in patients who underwent autologous stem cell transplantation with quinolonebased chemoprophylaxis. These changes may contribute to gastrointestinal toxicity and infections.
Hagiwara
Shotaro
S
Division of Hematology, Department of Internal Medicine, International Medical Center of Japan.
Hagiwara
Shotaro
S
Asahara
Takashi
T
Nomoto
Koji
K
Morotomi
Masami
M
Ishizuka
Naoki
N
Miwa
Akiyoshi
A
O Yoshida
Takato
T
D000143:Acids / Q000032:analysis; D019072:Antibiotic Prophylaxis; D005232:Fatty Acids, Volatile / Q000032:analysis; D005243:Feces / Q000737:chemistry* / Q000382:microbiology*; D005260:Female; D041981:Gastrointestinal Tract / Q000382:microbiology; D016905:Gram-Negative Bacterial Infections / Q000517:prevention & control*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009930:Organic Chemicals / Q000032:analysis*; D015363:Quinolones / Q000627:therapeutic use*; D014184:Transplantation, Homologous / Q000009:adverse effects; D016896:Treatment Outcome
D000143:Acids; D005232:Fatty Acids, Volatile; D009930:Organic Chemicals; D015363:Quinolones