Etiology and clinical features of post-engraftment blood stream infection in UCBT recipients
10.3760/cma.j.issn.0254-1785.2018.12.008
- VernacularTitle:非血缘脐血移植受者粒系植入后发生血流感染的临床研究
- Author:
Guangyu SUN
1
;
Changcheng ZHENG
;
Huilan LIU
;
Xiaoyu ZHU
;
Xiang WAN
;
Baolin TANG
;
Tianzhong PAN
;
Zimin SUN
Author Information
1. 中国科学技术大学附属第一医院安徽省立医院血液科
- Keywords:
Hematopoietic stem cell transplantation;
Bloodstream infection;
Neutrophil
- From:
Chinese Journal of Organ Transplantation
2018;39(12):740-744
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the epidemiologic and clinical features of post-engraftment blood stream infection (pePSI) after unrelated cord blood transplant (UCBT) in our hospital,and provide the basis for empiric antibacterial treatment.Methods 484 patients with hematological malignancies who received single-unit high intensity myeloablative UCBT in our hospital between April 2011 and November 2017 were enrolled.The incidence,etiology of BSI and associated mortality,drug resistance rate in the post-engraftment phase were investigated.Results Totally 25 episodes of BSI among 22 patients in the post-engraftment phase were documented,and the incidence of peBSI was 5 ％.Gram-negative organisms predominated over Gram positive,with Escherichia coli being the most frequent Gram-negative organism isolated (31.5％).Among Gram positive organisms,methicillin resistant Staphylococcus (MRS) was the most frequent species isolated (66％).Nearly 33％ of Escherichia coli isolates and 60％ Klebsiella pneumonia isolates were carbapenem-resistant.All Grampositive bacteria were sensitive to vaneomyein and linezolid.Among the 22 patients,14 patients were cured and survived (63％) eventually.Conclusion The most frequent causative agents of the peBSI after UCBT were Escherichia coli,Klebsiella pneumonia and MRS,etc.Combined antibacterial treatment including a carbapenem or beta lactamase inhibitor can be used for patients suffering fever in the post-engraftment phase as empiric antibacterial therapy.Vaneomyein and linezolid can be used as the first-line therapy for Gram-positive bacteria.
