title: Stenotrophomonas maltophilia infection during allogeneic hematopoietic stem cell transplantation: a single-center experience.
abstract: To examine risk factors for Stenotrophomonas maltophilia (S. maltophilia) infection during allogeneic hematopoietic stem cell transplantation (allo-HSCT), we retrospectively analyzed 259 patients who underwent allo-HSCT. Not only S. maltophilia infection but also S. maltophilia colonization was associated with mortality during allo-HSCT. Among 52 episodes in 39 patients in whom S. maltophilia was detected, documented infection developed in 33 episodes (25 patients). The onset of S. maltophilia infection in the period from the conditioning regimen to engraftment was associated with a high mortality rate. Breakthrough S. maltophilia infection developed in 24% of the patients during prophylactic administration of fluoroquinolones, to which S. maltophilia is sensitive. Reinsertion of a central venous catheter (CVC) immediately after removal was suggested to be a risk for persistent S. maltophilia infection in the period of neutropenia. Our results indicated that (i) onset of S. maltophilia infection in the period from the conditioning therapy to engraftment and (ii) removal and immediate reinsertion of a CVC as treatment after the onset of S. maltophilia infection are possible risk factors for S. maltophilia-related mortality during allo-HSCT.
authors.affiliation: Department of Hematology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Souichi
authors.initials: S
authors.lastname: Shiratori
authors.forename: Kentaro
authors.initials: K
authors.lastname: Wakasa
authors.forename: Kohei
authors.initials: K
authors.lastname: Okada
authors.forename: Junichi
authors.initials: J
authors.lastname: Sugita
authors.forename: Koji
authors.initials: K
authors.lastname: Akizawa
authors.forename: Akio
authors.initials: A
authors.lastname: Shigematsu
authors.forename: Daigo
authors.initials: D
authors.lastname: Hashimoto
authors.forename: Katsuya
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Endo
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kondo
authors.forename: Chikara
authors.initials: C
authors.lastname: Shimizu
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hashino
authors.forename: Takanori
authors.initials: T
authors.lastname: Teshima
mesh_terms: D000328:Adult; D000368:Aged; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000382:microbiology*; D005260:Female; D005500:Follow-Up Studies; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D020615:Stenotrophomonas maltophilia / Q000302:isolation & purification*; D015996:Survival Rate; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous
keywords: Stenotrophomonas maltophilia; allogeneic hematopoietic stem cell transplantation; bacterial infection; central venous catheter; neutropenia