PMID- 30423054
OWN - NLM
STAT- MEDLINE
DCOM- 20191107
LR  - 20191107
IS  - 1537-6591 (Electronic)
IS  - 1058-4838 (Linking)
VI  - 67
IP  - suppl_2
DP  - 2018 Nov 13
TI  - Incidence, Risk Factors, Microbiology and Outcomes of Pre-engraftment Bloodstream 
      Infection After Haploidentical Hematopoietic Stem Cell Transplantation and 
      Comparison With HLA-identical Sibling Transplantation.
PG  - S162-S173
LID - 10.1093/cid/ciy658 [doi]
AB  - BACKGROUND: Bloodstream infection (BSI) is a common and serious complication 
      after hematopoietic stem cell transplantation (HSCT). An investigation of the 
      characteristics of pre-engraftment BSI after haploidentical HSCT compared with 
      human leukocyte antigen (HLA)-identical sibling HSCT has not been conducted. 
      METHODS: A single-center cohort representing 1847 consecutive patients undergoing 
      haploidentical or HLA-identical sibling HSCT from 2013 to 2016 was selected. We 
      investigated the characteristics of pre-engraftment BSI after haploidentical HSCT 
      and its impact on patient outcome, and we compared it with HLA-identical sibling 
      HSCT. RESULTS: After haploidentical HSCT, the cumulative incidence of 
      pre-engraftment BSI was higher (30-day: 9.2% [7.6, 10.8] vs 1.7% [0.5, 2.9], P < 
      .0001) and median onset of BSI was earlier (day +3 vs day +9, P = .001) than 
      HLA-identical sibling HSCT. Escherichia coli, Klebsiella pneumoniae, and 
      coagulase-negative staphylococci were the most common isolates after 
      haploidentical HSCT. However, Enterococcus faecium was the most common isolate 
      after HLA-identical sibling HSCT. A multivariate analysis suggested that 
      variables associated with BSI after haploidentical HSCT included a diagnosis of 
      myelodysplastic syndrome (MDS), an interval from diagnosis to HSCT >/=190 days, 
      carbapenem therapy, and grade 3-4 intestinal mucositis. The same variables, 
      except MDS, were also associated with BSI after HLA-identical sibling HSCT. The 
      multivariate analysis also suggested that BSI was a risk factor for increased 
      all-cause mortality at 3 months after haploidentical HSCT (hazard ratio = 2.281; 
      95% confidence interval: 1.334, 3.900; P = .003). CONCLUSIONS: Pre-engraftment 
      BSI was more common after haploidentical HSCT than HLA-identical sibling HSCT. It 
      was an independent factor associated with increased all-cause mortality at 3 
      months after haploidentical HSCT.
FAU - Yan, Chen-Hua
AU  - Yan CH
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, China.
FAU - Wang, Yu
AU  - Wang Y
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, China.
FAU - Mo, Xiao-Dong
AU  - Mo XD
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, China.
FAU - Sun, Yu-Qian
AU  - Sun YQ
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, China.
FAU - Wang, Feng-Rong
AU  - Wang FR
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, China.
FAU - Fu, Hai-Xia
AU  - Fu HX
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, China.
FAU - Chen, Yao
AU  - Chen Y
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, China.
FAU - Han, Ting-Ting
AU  - Han TT
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, China.
FAU - Kong, Jun
AU  - Kong J
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, China.
FAU - Cheng, Yi-Fei
AU  - Cheng YF
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, China.
FAU - Zhang, Xiao-Hui
AU  - Zhang XH
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, China.
FAU - Xu, Lan-Ping
AU  - Xu LP
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, China.
FAU - Liu, Kai-Yan
AU  - Liu KY
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, China.
FAU - Huang, Xiao-Jun
AU  - Huang XJ
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, China.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Clin Infect Dis
JT  - Clinical infectious diseases : an official publication of the Infectious Diseases 
      Society of America
JID - 9203213
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Bacteremia/*microbiology/mortality
MH  - Bacteria/*isolation & purification
MH  - Child
MH  - Child, Preschool
MH  - China/epidemiology
MH  - Cohort Studies
MH  - Enterococcus faecium/isolation & purification
MH  - Female
MH  - HLA Antigens
MH  - Hematopoietic Stem Cell Transplantation/*adverse effects
MH  - Humans
MH  - Incidence
MH  - Infant
MH  - Klebsiella pneumoniae/isolation & purification
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Risk Factors
MH  - *Siblings
MH  - Staphylococcus/isolation & purification
MH  - Transplantation, Haploidentical/adverse effects
MH  - Young Adult
EDAT- 2018/11/14 06:00
MHDA- 2019/11/08 06:00
CRDT- 2018/11/14 06:00
PHST- 2018/11/14 06:00 [entrez]
PHST- 2018/11/14 06:00 [pubmed]
PHST- 2019/11/08 06:00 [medline]
AID - 5181287 [pii]
AID - 10.1093/cid/ciy658 [doi]
PST - ppublish
SO  - Clin Infect Dis. 2018 Nov 13;67(suppl_2):S162-S173. doi: 10.1093/cid/ciy658.