Analysis of incidence and risk factors of the multidrug resistant gastrointestinal tract infection in children and adolescents undergoing allogeneic and autologous hematopoietic cell transplantation: a nationwide study
| Autor: | Mariusz Wysocki, Krzysztof Czyżewski, Dorota Sęga-Pondel, Bernarda Kazanowska, Jolanta Goździk, Małgorzata Salamonowicz-Bodzioch, Jacek Wachowiak, Ewa Gorczyńska, Jadwiga Węcławek-Tompol, Jerzy Kowalczyk, Magdalena Dziedzic, Krzysztof Kałwak, Jowita Frączkiewicz, Jan Styczyński, Grażyna Wróbel, Marek Ussowicz, Agnieszka Zaucha-Prażmo, Olga Zając-Spychała |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Autologous transplantation medicine.medical_specialty Adolescent Gastrointestinal Diseases medicine.medical_treatment Gastrointestinal tract infection Graft vs Host Disease Hematopoietic stem cell transplantation Transplantation Autologous Risk Factors Drug Resistance Multiple Bacterial Internal medicine medicine Humans Transplantation Homologous Child Malignant diseases Hematology Clostridioides difficile business.industry Incidence Incidence (epidemiology) Infant Clostridium difficile Bacterial Infections General Medicine HLA Mismatch Pediatric hematology and oncology Transplantation Multiple drug resistance Gram-negative multidrug-resistant bacteria Child Preschool Clostridium Infections Original Article Female business |
| Zdroj: | Annals of Hematology |
| ISSN: | 1432-0584 0939-5555 |
| Popis: | The aim of this multi-center study was to evaluate the incidence, clinical course, and risk factors for bacterial multidrug-resistant (MDR) gastrointestinal tract infections (GTI) among children undergoing allogeneic and autologous hematopoietic cell transplantation. A total number of 175 pediatric patients (aged 1–18 years), transplanted between January 2018 and December 2019, who were tested for bacterial colonization/infection were enrolled into this multi-center analysis. Episodes of MDR GTI occurred in 77/175 (44%) patients. In multivariate analysis for higher GTI incidence, the following factors were significant: matched-unrelated donor (MUD) transplantation, HLA mismatch, presence of graft-versus-host disease (GVHD), and gut GVHD. The most common GTI were Clostridium difficile (CDI), multidrug-resistant Enterobacteriaceae (Klebsiella pneumoniae, Escherichia coli extended-spectrum β-lactamase), and Enterococcus HLAR (high-level aminoglycoside-resistant). No MDR GTI–attributed deaths were reported. MDR GTI is a frequent complication after HCT among children, causes prolonged hospitalization, but rarely contributes to death. We identified risk factors of MDR GTI development in children, with focus on GVHD and unrelated donor and HLA mismatch. We conclude that the presence of Clostridiales plays an important anti-inflammatory homeostatic role and decreases incidence of GVHD or alleviate its course. |
| Databáze: | OpenAIRE |
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