Source, pattern and antibiotic resistance of blood stream infections in hematopoietic stem cell transplant recipients.
Mucositis developing as a result of myelo-ablative high dose therapy administered prior to hematopoietic stem cell transplantation (HSCT) is associated with the risk of bacteremia. The aim of the present study was to detect the pattern of bacteremia coinciding with the present practice of HSCT, to study the contribution of health-care associated infection (HAI) to the pattern of infection, in the context of the problem of antibiotic resistance in HSCT recipients.


METHODS
This is a retrospective, single center study including patients who developed febrile neutropenia (FN) among HSCT recipients in one year duration.


RESULTS
Ninety FN episodes were recorded in 50 patients. Out of 39 positive blood cultures, Gram negative rods (GNR) were the predominant pathogens, constituting 67% (n=26) of isolated organisms, while 33% of infections were caused by gram positive cocci (GPC) (n=13). Bacteremia was significantly associated with central venous line (CVL) infections and gastroenteritis (diarrhea and vomiting) with a p-value 0.024, 0.20 and 0.0001, respectively. Multi-drug resistant organisms (MDROs) were identified in 27 (69%) of the 39 positive blood cultures.


CONCLUSIONS
In one year duration, gram negative pathogens were the predominant causes of infection in HSCT recipients with high rates of MDROs in our institution. Gastroenteritis and central venous line infections are the main sources of bacteremia.
Clinical Pathology department, National Cancer Institute (NCI), Cairo University, Egypt.
Hadir
H
El-Mahallawy
Clinical Pathology department, National Cancer Institute (NCI), Cairo University, Egypt.
Iman
I
Samir
Medical Oncology Department, National Cancer Institute (NCI), Cairo University, Egypt.
Raafat
R
Abdel Fattah
Clinical Pathology department, National Cancer Institute (NCI), Cairo University, Egypt. Electronic address: dykadry@yahoo.com.
Dalia
D
Kadry
Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Egypt.
Amany
A
El-Kholy
D000293:Adolescent; D000328:Adult; D016470:Bacteremia / Q000097:blood* / Q000209:etiology / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D004352:Drug Resistance, Microbial / Q000235:genetics*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006412:Hematopoietic Stem Cells / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D066027:Transplant Recipients
Bacteremia; Hematopoietic stem cell transplantation (HSCT); Multi-drug resistant organisms (MDRO)