title: Multidrug-resistant organisms in allogeneic hematopoietic cell transplantation.
abstract: OBJECTIVE
  Multidrug-resistant organisms (MDRO) are a challenge in allogeneic hematopoietic cell transplantation (HCT). However, in the literature there is no comprehensive analysis on MDRO in HCT. In this retrospective, single-center analysis, we appraised prevalence and clinical impact of MDRO in 98 consecutive allogeneic HCT patients.
  
  
  METHODS
  Prior to the conditioning (baseline) and whenever clinically indicated patients underwent a full screening for MDRO (stool and urine cultures, swabs from several body regions).
  
  
  RESULTS
  It turned out that 26 patients were colonized by 33 MDRO, either at baseline (n=16) or at any other time until day 100 post-transplantation. Of these 26 patients, eight developed an infection with MDRO, four of them by 4MRGN Pseudomonas aeruginosa, and three of them died MDRO-related. However, there was no significant difference between MDRO-colonized and non-colonized patients regarding overall survival (OS) and non-relapse-mortality (NRM). There was only a trend toward a higher NRM in patients already colonized by MDRO at baseline. This was due to the high NRM in multidrug-resistant P. aeruginosa-colonized patients.
  
  
  CONCLUSIONS
  In summary, colonization with MDRO other than P. aeruginosa had no negative impact on NRM and OS. Patients colonized by multidrug-resistant P. aeruginosa had a dismal outcome. HCT of these patients should be considered with care. Screening for MDRO in the pretransplant work-up is suggested.
authors.affiliation: III. Medizinische Klinik, Universitätsmedizin Mannheim, Mannheim, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Heidenreich
authors.affiliation: III. Medizinische Klinik, Universitätsmedizin Mannheim, Mannheim, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kreil
authors.affiliation: III. Medizinische Klinik, Universitätsmedizin Mannheim, Mannheim, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Nolte
authors.affiliation: III. Medizinische Klinik, Universitätsmedizin Mannheim, Mannheim, Germany.
authors.forename: Wolf K
authors.initials: WK
authors.lastname: Hofmann
authors.affiliation: Institut für Medizinische Mikrobiologie und Hygiene, Universitätsmedizin Mannheim, Mannheim, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Miethke
authors.affiliation: III. Medizinische Klinik, Universitätsmedizin Mannheim, Mannheim, Germany.
authors.forename: Stefan A
authors.initials: SA
authors.lastname: Klein
mesh_terms: D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000494:pharmacology; D019468:Disease Management; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D064147:Febrile Neutropenia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007239:Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009026:Mortality; D015995:Prevalence; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents
keywords: allogeneic hematopoietic cell transplantation; colonization; infection; multidrug-resistant Pseudomonas aeruginosa; multidrug-resistant organisms