The Changing Epidemiology of Bloodstream Infections and Resistance in Hematopoietic Stem Cell Transplantation Recipients

• Published in: Turkish journal of haematology Vol. 33; no. 3; pp. 216 - 222
• Main Authors: Yemişen, Mücahit, Balkan, İlker İnanç, Salihoğlu, Ayşe, Eşkazan, Ahmet Emre, Mete, Bilgül, Ar, M Cem, Öngören, Şeniz, Başlar, Zafer, Özaras, Reşat, Saltoğlu, Neşe, Mert, Ali, Ferhanoğlu, Burhan, Öztürk, Recep, Tabak, Fehmi, Soysal, Teoman
• Format: Journal Article
• Language: English
• Published: Turkey Galenos Publishing 05-09-2016; Galenos Publishing House
• Subjects: Adolescent; Adult; Aged; Bacteria - drug effects; Bacteria - genetics; Bacteria - isolation & purification; Bacterial Infections - blood; Bacterial Infections - drug therapy; Bacterial Infections - epidemiology; Bacterial Infections - microbiology; bloodstream infection; central venous catheter; Drug Resistance, Microbial - drug effects; epidemiology; Female; Hematopoietic Stem Cell Transplantation; Hodgkin Disease - complications; Hodgkin Disease - epidemiology; Hodgkin Disease - microbiology; Hodgkin Disease - therapy; Humans; Male; Middle Aged; Multiple Myeloma - complications; Multiple Myeloma - epidemiology; Multiple Myeloma - microbiology; Multiple Myeloma - therapy; resistance; Retrospective Studies; Young Adult
• ISSN: 1300-7777; 1308-5263
• DOI: 10.4274/tjh.2014.0378

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