title: Comparison of characteristics of bacterial bloodstream infection between adult patients with allogeneic and autologous hematopoietic stem cell transplantation.
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.
authors.affiliation: Division of Hematology and Medical Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon, Republic of Korea.
authors.forename: Junshik
authors.initials: J
authors.lastname: Hong
authors.forename: Song Mi
authors.initials: SM
authors.lastname: Moon
authors.forename: Hee Kyung
authors.initials: HK
authors.lastname: Ahn
authors.forename: Sun Jin
authors.initials: SJ
authors.lastname: Sym
authors.forename: Yoon Soo
authors.initials: YS
authors.lastname: Park
authors.forename: Jinny
authors.initials: J
authors.lastname: Park
authors.forename: Yong Kyun
authors.initials: YK
authors.lastname: Cho
authors.forename: Eun Kyung
authors.initials: EK
authors.lastname: Cho
authors.forename: Dong Bok
authors.initials: DB
authors.lastname: Shin
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000150:complications / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*; D016905:Gram-Negative Bacterial Infections / Q000150:complications / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*; D016908:Gram-Positive Bacterial Infections / Q000150:complications / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology*; D012189:Retrospective Studies; D016019:Survival Analysis; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous
chemical_list: D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents