title: Is surveillance for colonization of carbapenem-resistant gram-negative bacteria important in adult bone marrow transplantation units?
abstract: BACKGROUND
  The aim of this study was to investigate the rate of carbapenem-resistant gram-negative bacilli (CRGNB) colonization and to analyze the risk factors associated with CRGNB colonization.
  
  
  METHODS
  This prospective study was conducted in adult patients hospitalized in hematopoietic stem cell transplantation (HSCT) units over a period of 8 months. Rectal swab samples were obtained from each participant every Monday, and patients CRGNB positive on admission were excluded.
  
  
  RESULTS
  Of 185 participants, the median age was 47 years, and 59.5% were men. CRGNB colonization was detected in 21 (11.4%) patients. The most commonly isolated CRGNB were Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Multivariate analysis revealed that busulfan use (11.9 times), fludarabine use (6.4 times), transfer from another hospital (7.8 times), transfer between units (9.3 times), and central venous catheterization (5.1 times) were risk factors for CRGNB colonization. During the study period, febrile neutropenia (FN) developed in 9 (56.2%) of the 21 colonized patients, and 1 patient died.
  
  
  CONCLUSIONS
  Screening of patients for CRGNB colonization may have a role in preventing the spread of CRGNB. However, the empirical antimicrobial treatment for FN in patients with CRGNB colonization did not change, and their mortality rates were similar.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Erciyes University, Melikgazi, Kayseri, Turkey. Electronic address: tigin68@hotmail.com.
authors.forename: Hayati
authors.initials: H
authors.lastname: Demiraslan
authors.affiliation: Infection Control Committee, Erciyes University, Kayseri, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Cevahir
authors.affiliation: Department of Medical Microbiology, Erciyes University, Kayseri, Turkey.
authors.forename: Elife
authors.initials: E
authors.lastname: Berk
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Hacettepe University, Ankara, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Metan
authors.affiliation: Department of Hematology, Erciyes University, Kayseri, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cetin
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Erciyes University, Melikgazi, Kayseri, Turkey; Infection Control Committee, Erciyes University, Kayseri, Turkey.
authors.forename: Emine
authors.initials: E
authors.lastname: Alp
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001426:Bacterial Proteins / Q000378:metabolism*; D016026:Bone Marrow Transplantation; D002353:Carrier State / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D062665:Epidemiological Monitoring; D005260:Female; D006090:Gram-Negative Bacteria / Q000201:enzymology* / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D001426:Bacterial Proteins; D001618:beta-Lactamases; C063912:carbapenemase
keywords: Carbapenem resistance; Gram-negative bacterial colonization; HSCT; Hematopoietic stem cell transplantation; Risk factors; Surveillance