The Changing Epidemiology of Bloodstream Infections and Resistance in Hematopoietic Stem Cell Transplantation Recipients.
OBJECTIVE
Patients receiving hematopoietic stem cell transplantation (HSCT) are exposed to highly immunosuppressive conditions and bloodstream infections (BSIs) are one of the most common major complications within this period. Our aim, in this study, was to evaluate the epidemiology of BSIs in these patients retrospectively.


METHODS
The epidemiological properties of 312 patients with HSCT were retrospectively evaluated.


RESULTS
A total of 312 patients, followed between 2000 and 2011, who underwent autologous (62%) and allogeneic (38%) HSCT were included in the study. The most common underlying malignancies were multiple myeloma (28%) and Hodgkin lymphoma (21.5%). A total of 142 (45%) patients developed at least 1 episode of BSI and 193 separate pathogens were isolated from the blood cultures. There was a trend of increase in the numbers of BSIs in 2005-2008 and a relative increase in the proportion of gram-positive infections in recent years (2009-2011), and central venous catheter-related BSI was found to be most common source. Coagulase-negative staphylococci (49.2%) and Acinetobacter baumannii (8.8%) were the most common pathogens. Extended-spectrum beta-lactamase-producing strains were 23% and 22% among Escherichia coli and Klebsiella spp. isolates, respectively. Quinolone resistance was detected in 10% of Enterobacteriaceae. Resistance to carbapenems was not detected in Enterobacteriaceae, while it was seen at 11.1% and 23.5% in Pseudomonas and Acinetobacter strains, respectively.


CONCLUSIONS
A shift was detected from gram-negative bacteria to gram-positive in the etiology over the years and central lines were the most common sources of BSIs.
İstanbul University Cerrahpaşa Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, İstanbul, Turkey Phone : +90 212 414 30 95 E-mail: yemisenmucahit@hotmail.com.
Mücahit
M
Yemişen
İlker İnanç
İİ
Balkan
Ayşe
A
Salihoğlu
Ahmet Emre
AE
Eşkazan
Bilgül
B
Mete
M Cem
MC
Ar
Şeniz
Ş
Öngören
Zafer
Z
Başlar
Reşat
R
Özaras
Neşe
N
Saltoğlu
Ali
A
Mert
Burhan
B
Ferhanoğlu
Recep
R
Öztürk
Fehmi
F
Tabak
Teoman
T
Soysal
D000293:Adolescent; D000328:Adult; D000368:Aged; D001419:Bacteria / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D004352:Drug Resistance, Microbial / Q000187:drug effects*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006689:Hodgkin Disease / Q000150:complications / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy*; D012189:Retrospective Studies; D055815:Young Adult