Reference : Bacteremia after hematopoietic stem cell transplantation: incidence and predictive va...
Scientific journals : Article
Human health sciences : Hematology
http://hdl.handle.net/2268/9391
Bacteremia after hematopoietic stem cell transplantation: incidence and predictive value of surveillance cultures.
English
Frere, Pascale mailto [Centre Hospitalier Universitaire de Liège - CHU > > Hématologie clinique >]
Hermanne, J.-P. [> > > >]
Debouge, M.-H. [> > > >]
De Mol, Patrick mailto [Centre Hospitalier Universitaire de Liège - CHU > > Microbiologie médicale >]
Fillet, Georges mailto [Centre Hospitalier Universitaire de Liège - CHU > > Hématologie clinique >]
Beguin, Yves mailto [Centre Hospitalier Universitaire de Liège - CHU > > Hématologie clinique >]
2004
Bone Marrow Transplantation
Nature Publishing Group
33
7
745-9
Yes (verified by ORBi)
International
0268-3369
London
United Kingdom
[en] Adolescent ; Adult ; Aged ; Bacteremia/diagnosis/epidemiology/etiology ; Bacteria/classification/cytology/isolation & purification ; Child ; Child, Preschool ; Female ; Fungemia/diagnosis/epidemiology ; Hematopoietic Stem Cell Transplantation/adverse effects ; Humans ; Incidence ; Infant ; Male ; Microbial Sensitivity Tests ; Microbiological Techniques ; Middle Aged ; Predictive Value of Tests ; Retrospective Studies ; Serotyping ; Transplantation, Autologous ; Transplantation, Homologous
[en] We studied 622 transplants undertaken between 1982 and 2001 to: (1) determine the incidence, timing and etiology of bacteremias, and (2) examine the ability of routine surveillance cultures to predict bacteremias. A total of 404 episodes (0.65 episode per patient) occurred in 248 patients, due to coagulase-negative staphylococci (n=171, 42%), Gram-negative bacteria (n=129, 32%), streptococci (n=48, 12%), other Gram-positive bacteria (n=33, 8%), anaerobes (n=9, 2%) and fungi (n=14, 3%). Bacteremias were more frequent in allogeneic (0.96 episode/patient) compared to autologous (0.44) transplants (P<0.0001). The overall incidence decreased from 0.92 episode/patient until 1990 to 0.66 in 1991-1996 and 0.55 in 1997-2001 (P<0.0001), but this was only observed in autologous transplants. Among them, 212 (53%) occurred before hospital discharge and 192 (47%) thereafter. This proportion was lower for coagulase-negative staphylococci, other Gram-positive bacteria and Gram-negative bacteria compared to other agents (P=0.001). In 50% of the cases, the agent responsible for the bacteremic episode was present in routine surveillance cultures previously. In conclusion: (1) bacteremias remain a frequent complication, particularly in allogeneic transplantation, even long after hospital discharge; (2) routine surveillance cultures can predict bacteremias in 50% of the cases, but the practical impact of this observation is limited in view of the costs.
http://hdl.handle.net/2268/9391
10.1038/sj.bmt.1704414

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