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Incidence, Risk Factors and Outcome of Pre-engraftment Gram-Negative Bacteremia after Allogeneic and Autologous Hematopoietic Stem Cell Transplantation: An Italian Prospective Multicenter Survey

Authors :
Girmenia, C.
Bertaina, A.
Piciocchi, A.
Perruccio, K.
Algarotti, A.
Busca, A.
Cattaneo, C.
Raiola, A. M.
Guidi, S.
Iori, A. P.
Candoni, A.
Irrera, G.
Milone, G.
Marcacci, G.
Scime, R.
Musso, M.
Cudillo, L.
Sica, Simona
Castagna, Luigi
Corradini, P.
Marchesi, F.
Pastore, D.
Alessandrino, E. P.
Annaloro, C.
Ciceri, F.
Santarone, S.
Nassi, L.
Farina, C.
Viscoli, C.
Rossolini, G. M.
Bonifazi, F.
Rambaldi, A.
Capria, S.
Mastronuzzi, A.
Pagliara, D.
Bernaschi, P.
Amico, L.
Carotti, A.
Mencacci, A.
Bruno, Brunella
Costa, C.
Passi, A.
Ravizzola, G.
Angelucci, E.
Marchese, Alessandra Maria
Pecile, P.
Ventura, Giulio
Fanin, R.
Scarparo, C.
Barbaro, A.
Leotta, Salvatore Nuccio
Marchese, A. E.
Becchimanzi, C.
Donnarumma, D.
Tringali, S.
Baldi, M. T.
Scalone, R.
Picardi, A.
Arcese, W.
Fontana, Cecilia Alejandra
Giammarco, S.
Spanu, Teresa
Crocchiolo, R.
Casari, E.
Mussetti, A.
Conte, Eliana
Ensoli, F.
Miragliotta, G.
Marone, P.
Arghittu, M.
Greco, R.
Forcina, A.
Chichero, P.
Di Bartolomeo, P.
Fazii, P.
Kroumova, V.
Decembrino, N.
Zecca, M.
Pisapia, Giovanni
Palazzo, G.
Lanino, E.
Faraci, M.
Castagnola, E.
Bandettini, R.
Pastano, R.
Sammassimo, S.
Passerini, R.
Stefani, P. M.
Gherlinzoni, F.
Rigoli, R.
Prezioso, L.
Cambo, B.
Calderaro, A.
Carella, A. M.
Cascavilla, N.
Labonia, M. T.
Celeghini, I.
Mordini, N.
Piana, F.
Vacca, A.
Sanna, Maria Maddalena
Podda, G.
Corsetti, M. T.
Rocchetti, A.
Cilloni, D.
De Gobbi, M.
Bianco, O.
Fagioli, F.
Carraro, F.
De Intinis, G.
Severino, A.
Proia, Anna Silvia
Parisi, G.
Vallisa, D.
Confalonieri, Marco
Russo, D.
Malagola, M.
Galieni, P.
Falcioni, S.
Travaglini, V.
Raimondi, Maria Rosa
Borghero, C.
Pavan, Giuseppe
Prete, A.
Belotti, T.
Ambretti, S.
Imola, M.
Mianulli, A. M.
Pedna, M. F.
Cesaro, S.
Lo Cascio, G.
Ferrari, A.
Piedimonte, M.
Santino, I.
Calandrelli, M.
Olivieri, Alessandra
Orecchioni, F.
Mirabile, M.
Centurioni, R.
Gironacci, L.
Caravelli, D.
Gallo, S.
De Filippi, M.
Cupelli, L.
Dentamaro, T.
Falco, S.
Eugenio, O. S.
Marotta, S.
Risitano, A.
Lula, D.
Musto, P.
Pietrantuono, G.
Traficante, A.
Cerchiara, E.
Tirindelli, M. C.
Dicuonzo, G.
Chierichini, A.
Anaclerico, B.
Placanica, P.
Sica S. (ORCID:0000-0003-2426-3465)
Castagna L.
Bruno B.
Marchese A.
Ventura G. (ORCID:0000-0002-0304-7264)
Leotta S.
Fontana C.
Spanu T. (ORCID:0000-0003-1864-5184)
Conte E.
Pisapia G.
Sanna M.
Proia A.
Confalonieri M. (ORCID:0000-0002-3708-379X)
Raimondi R.
Pavan G.
Olivieri A.
Girmenia, C.
Bertaina, A.
Piciocchi, A.
Perruccio, K.
Algarotti, A.
Busca, A.
Cattaneo, C.
Raiola, A. M.
Guidi, S.
Iori, A. P.
Candoni, A.
Irrera, G.
Milone, G.
Marcacci, G.
Scime, R.
Musso, M.
Cudillo, L.
Sica, Simona
Castagna, Luigi
Corradini, P.
Marchesi, F.
Pastore, D.
Alessandrino, E. P.
Annaloro, C.
Ciceri, F.
Santarone, S.
Nassi, L.
Farina, C.
Viscoli, C.
Rossolini, G. M.
Bonifazi, F.
Rambaldi, A.
Capria, S.
Mastronuzzi, A.
Pagliara, D.
Bernaschi, P.
Amico, L.
Carotti, A.
Mencacci, A.
Bruno, Brunella
Costa, C.
Passi, A.
Ravizzola, G.
Angelucci, E.
Marchese, Alessandra Maria
Pecile, P.
Ventura, Giulio
Fanin, R.
Scarparo, C.
Barbaro, A.
Leotta, Salvatore Nuccio
Marchese, A. E.
Becchimanzi, C.
Donnarumma, D.
Tringali, S.
Baldi, M. T.
Scalone, R.
Picardi, A.
Arcese, W.
Fontana, Cecilia Alejandra
Giammarco, S.
Spanu, Teresa
Crocchiolo, R.
Casari, E.
Mussetti, A.
Conte, Eliana
Ensoli, F.
Miragliotta, G.
Marone, P.
Arghittu, M.
Greco, R.
Forcina, A.
Chichero, P.
Di Bartolomeo, P.
Fazii, P.
Kroumova, V.
Decembrino, N.
Zecca, M.
Pisapia, Giovanni
Palazzo, G.
Lanino, E.
Faraci, M.
Castagnola, E.
Bandettini, R.
Pastano, R.
Sammassimo, S.
Passerini, R.
Stefani, P. M.
Gherlinzoni, F.
Rigoli, R.
Prezioso, L.
Cambo, B.
Calderaro, A.
Carella, A. M.
Cascavilla, N.
Labonia, M. T.
Celeghini, I.
Mordini, N.
Piana, F.
Vacca, A.
Sanna, Maria Maddalena
Podda, G.
Corsetti, M. T.
Rocchetti, A.
Cilloni, D.
De Gobbi, M.
Bianco, O.
Fagioli, F.
Carraro, F.
De Intinis, G.
Severino, A.
Proia, Anna Silvia
Parisi, G.
Vallisa, D.
Confalonieri, Marco
Russo, D.
Malagola, M.
Galieni, P.
Falcioni, S.
Travaglini, V.
Raimondi, Maria Rosa
Borghero, C.
Pavan, Giuseppe
Prete, A.
Belotti, T.
Ambretti, S.
Imola, M.
Mianulli, A. M.
Pedna, M. F.
Cesaro, S.
Lo Cascio, G.
Ferrari, A.
Piedimonte, M.
Santino, I.
Calandrelli, M.
Olivieri, Alessandra
Orecchioni, F.
Mirabile, M.
Centurioni, R.
Gironacci, L.
Caravelli, D.
Gallo, S.
De Filippi, M.
Cupelli, L.
Dentamaro, T.
Falco, S.
Eugenio, O. S.
Marotta, S.
Risitano, A.
Lula, D.
Musto, P.
Pietrantuono, G.
Traficante, A.
Cerchiara, E.
Tirindelli, M. C.
Dicuonzo, G.
Chierichini, A.
Anaclerico, B.
Placanica, P.
Sica S. (ORCID:0000-0003-2426-3465)
Castagna L.
Bruno B.
Marchese A.
Ventura G. (ORCID:0000-0002-0304-7264)
Leotta S.
Fontana C.
Spanu T. (ORCID:0000-0003-1864-5184)
Conte E.
Pisapia G.
Sanna M.
Proia A.
Confalonieri M. (ORCID:0000-0002-3708-379X)
Raimondi R.
Pavan G.
Olivieri A.
Publication Year :
2017

Abstract

Background Gram-negative bacteremia (GNB) is a major cause of illness and death after hematopoietic stem cell transplantation (HSCT), and updated epidemiological investigation is advisable. Methods We prospectively evaluated the epidemiology of pre-engraftment GNB in 1118 allogeneic HSCTs (allo-HSCTs) and 1625 autologous HSCTs (auto-HSCTs) among 54 transplant centers during 2014 (SIGNB-GITMO-AMCLI study). Using logistic regression methods. we identified risk factors for GNB and evaluated the impact of GNB on the 4-month overall-survival after transplant. Results The cumulative incidence of pre-engraftment GNB was 17.3% in allo-HSCT and 9% in auto-HSCT. Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa were the most common isolates. By multivariate analysis, variables associated with GNB were a diagnosis of acute leukemia, a transplant from a HLA-mismatched donor and from cord blood, older age, and duration of severe neutropenia in allo-HSCT, and a diagnosis of lymphoma, older age, and no antibacterial prophylaxis in auto-HSCT. A pretransplant infection by a resistant pathogen was significantly associated with an increased risk of posttransplant infection by the same microorganism in allo-HSCT. Colonization by resistant gram-negative bacteria was significantly associated with an increased rate of infection by the same pathogen in both transplant procedures. GNB was independently associated with increased mortality at 4 months both in allo-HSCT (hazard ratio, 2.13; 95% confidence interval, 1.45-3.13; P <.001) and auto-HSCT (2.43; 1.22-4.84; P =.01). Conclusions Pre-engraftment GNB is an independent factor associated with increased mortality rate at 4 months after auto-HSCT and allo-HSCT. Previous infectious history and colonization monitoring represent major indicators of GNB. Clinical Trials registration NCT02088840.

Details

Database :
OAIster
Notes :
English
Publication Type :
Electronic Resource
Accession number :
edsoai.on1242039857
Document Type :
Electronic Resource