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

Corrado Girmenia; Alice Bertaina; Alfonso Piciocchi; Katia Perruccio; Alessandra Algarotti; Alessandro Busca; Chiara Cattaneo; Anna Maria Raiola; Stefano Guidi; Anna Paola Iori; Anna Candoni; Giuseppe Irrera; Giuseppe Milone; Giampaolo Marcacci; Rosanna Scimè; Maurizio Musso; Laura Cudillo; Simona Sica; Luca Castagna; Luigi Castagna; Paolo Corradini; Francesco Marchesi; Domenico Pastore; Emilio Paolo Alessandrino; Claudio Annaloro; Fabio Ciceri; Stella Santarone; Luca Nassi; Claudio Farina; Claudio Viscoli; Gian Maria Rossolini; Francesca Bonifazi; Alessandro Rambaldi; Saveria Capria; Angela Mastronuzzi; Daria Pagliara; Paola Bernaschi; Lucia Amico; Alessandra Carotti; Antonella Mencacci; Benedetto Bruno; Brunella Bruno; Cristina Costa; Angela Passi; Giuseppe Ravizzola; Emanuele Angelucci; Anna Marchese; Alessandra Maria Marchese; Patrizia Pecile; Giovanna Ventura; Giulio Ventura; Renato Fanin; Claudio Scarparo; Angelo Barbaro; Salvatore Leotta; Salvatore Nuccio Leotta; Anna Elisa Marchese; Cristina Becchimanzi; Daniela Donnarumma; Stefania Tringali; Maria Teresa Baldi; Renato Scalone; Alessandra Picardi; William Arcese; Carla Fontana; Cecilia Alejandra Fontana; Sabrina Giammarco; Teresa Spanu Pennestri; Roberto Crocchiolo; Erminia Casari; Alberto Mussetti; Eutilia Conte; Eliana Conte; Fabrizio Ensoli; Giuseppe Miragliotta; Piero Marone; Milena Arghittu; Raffaella Greco; Alessandra Forcina; Paola Chichero; Paolo Di Bartolomeo; Paolo Fazii; Vesselina Kroumova; Nunzia Decembrino; Marco Zecca; Giovanni Pisapia; Giulia Palazzo; Edoardo Lanino; Maura Faraci; Elio Castagnola; Roberto Bandettini; Rocco Pastano; Simona Sammassimo; Rita Passerini; Piero Maria Stefani; Filippo Gherlinzoni; Roberto Rigoli; Lucia Prezioso; Benedetta Cambò; Adriana Calderaro; Angelo Michele Carella; Nicola Cascavilla; Maria Teresa Labonia; Ivana Celeghini; Nicola Mordini; Federica Piana; Adriana Vacca; Marco Sanna; Maria Maddalena Sanna; Giovanni Podda; Maria Teresa Corsetti; Andrea Rocchetti; Daniela Cilloni; Marco De Gobbi; Ornella Bianco; Franca Fagioli; Francesca Carraro; Gianfranco De Intinis; Alessandro Severino; Anna Proia; Anna Silvia Proia; Gabriella Parisi; Daniele Vallisa; Massimo Confalonieri; Marco Confalonieri; Domenico Russo; Michele Malagola; Piero Galieni; Sadia Falcioni; Valeria Travaglini; Roberto Raimondi; Maria Rosa Raimondi; Carlo Borghero; Giacomina Pavan; Giuseppe Pavan; Arcangelo Prete; Tamara Belotti; Simone Ambretti; Manuela Imola; Anna Maria Mianulli; Maria Federica Pedna; Simone Cesaro; Giuliana Lo Cascio; Antonella Ferrari; Monica Piedimonte; Iolanda Santino; Monica Calandrelli; Attilio Olivieri; Alessandra Olivieri; Francesca Orecchioni; Milena Mirabile; Riccardo Centurioni; Luciana Gironacci; Daniela Caravelli; Susanna Gallo; Marco De Filippi; Luca Cupelli; Teresa Dentamaro; Silvana Falco; Ospedale S Eugenio; Serena Marotta; Antonio Risitano; Dora Lula; Pellegrino Musto; Giuseppe Pietrantuono; Antonio Traficante; Elisabetta Cerchiara; Maria Cristina Tirindelli; Giordano Dicuonzo; Anna Chierichini; Barbara Anaclerico; Paola Placanica

doi:10.1093/cid/cix690

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

Corrado Girmenia, Alice Bertaina, Alfonso Piciocchi, Katia Perruccio, Alessandra Algarotti, Alessandro Busca, Chiara Cattaneo, Anna Maria Raiola, Stefano Guidi, Anna Paola Iori, Anna Candoni, Giuseppe Irrera, Giuseppe Milone, Giampaolo Marcacci, Rosanna Scimè, Maurizio Musso, Laura Cudillo, Simona Sica, Luca Castagna, Luigi CastagnaPaolo Corradini, Francesco Marchesi, Domenico Pastore, Emilio Paolo Alessandrino, Claudio Annaloro, Fabio Ciceri, Stella Santarone, Luca Nassi, Claudio Farina, Claudio Viscoli, Gian Maria Rossolini, Francesca Bonifazi, Alessandro Rambaldi, Saveria Capria, Angela Mastronuzzi, Daria Pagliara, Paola Bernaschi, Lucia Amico, Alessandra Carotti, Antonella Mencacci, Benedetto Bruno, Brunella Bruno, Cristina Costa, Angela Passi, Giuseppe Ravizzola, Emanuele Angelucci, Anna Marchese, Alessandra Maria Marchese, Patrizia Pecile, Giovanna Ventura, Giulio Ventura, Renato Fanin, Claudio Scarparo, Angelo Barbaro, Salvatore Leotta, Salvatore Nuccio Leotta, Anna Elisa Marchese, Cristina Becchimanzi, Daniela Donnarumma, Stefania Tringali, Maria Teresa Baldi, Renato Scalone, Alessandra Picardi, William Arcese, Carla Fontana, Cecilia Alejandra Fontana, Sabrina Giammarco, Teresa Spanu Pennestri, Roberto Crocchiolo, Erminia Casari, Alberto Mussetti, Eutilia Conte, Eliana Conte, Fabrizio Ensoli, Giuseppe Miragliotta, Piero Marone, Milena Arghittu, Raffaella Greco, Alessandra Forcina, Paola Chichero, Paolo Di Bartolomeo, Paolo Fazii, Vesselina Kroumova, Nunzia Decembrino, Marco Zecca, Giovanni Pisapia, Giulia Palazzo, Edoardo Lanino, Maura Faraci, Elio Castagnola, Roberto Bandettini, Rocco Pastano, Simona Sammassimo, Rita Passerini, Piero Maria Stefani, Filippo Gherlinzoni, Roberto Rigoli, Lucia Prezioso, Benedetta Cambò, Adriana Calderaro, Angelo Michele Carella, Nicola Cascavilla, Maria Teresa Labonia, Ivana Celeghini, Nicola Mordini, Federica Piana, Adriana Vacca, Marco Sanna, Maria Maddalena Sanna, Giovanni Podda, Maria Teresa Corsetti, Andrea Rocchetti, Daniela Cilloni, Marco De Gobbi, Ornella Bianco, Franca Fagioli, Francesca Carraro, Gianfranco De Intinis, Alessandro Severino, Anna Proia, Anna Silvia Proia, Gabriella Parisi, Daniele Vallisa, Massimo Confalonieri, Marco Confalonieri, Domenico Russo, Michele Malagola, Piero Galieni, Sadia Falcioni, Valeria Travaglini, Roberto Raimondi, Maria Rosa Raimondi, Carlo Borghero, Giacomina Pavan, Giuseppe Pavan, Arcangelo Prete, Tamara Belotti, Simone Ambretti, Manuela Imola, Anna Maria Mianulli, Maria Federica Pedna, Simone Cesaro, Giuliana Lo Cascio, Antonella Ferrari, Monica Piedimonte, Iolanda Santino, Monica Calandrelli, Attilio Olivieri, Alessandra Olivieri, Francesca Orecchioni, Milena Mirabile, Riccardo Centurioni, Luciana Gironacci, Daniela Caravelli, Susanna Gallo, Marco De Filippi, Luca Cupelli, Teresa Dentamaro, Silvana Falco, Ospedale S Eugenio, Serena Marotta, Antonio Risitano, Dora Lula, Pellegrino Musto, Giuseppe Pietrantuono, Antonio Traficante, Elisabetta Cerchiara, Maria Cristina Tirindelli, Giordano Dicuonzo, Anna Chierichini, Barbara Anaclerico, Paola Placanica

Risultato della ricerca: Contributo in rivista › Articolo in rivista

45 Citazioni (Scopus)

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.

Lingua originale	English
pagine (da-a)	1884-1896
Numero di pagine	13
Rivista	Clinical Infectious Diseases
Volume	65
DOI	https://doi.org/10.1093/cid/cix690
Stato di pubblicazione	Pubblicato - 2017

Keywords

Adolescent
Adult
Age Factors
Aged
Bacteremia
Child
Child, Preschool
Drug Resistance, Multiple, Bacterial
Escherichia coli
Female
Gram negative bacteremia
Gram-Negative Bacteria
Gram-Negative Bacterial Infections
Hematopoietic Stem Cell Transplantation
Humans
Incidence
Infant
Italy
Male
Middle Aged
Prospective Studies
Risk Factors
Transplantation Conditioning
Transplantation, Autologous
Transplantation, Homologous
Young Adult
epidemiology
multidrug resistance
stem cell transplant
survival

Accesso al documento

10.1093/cid/cix690

Altri file e collegamenti

Link a IRIS PubliCatt

Cita questo

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., Scimè, R., Musso, M., Cudillo, L., Sica, S., Castagna, L., ... Placanica, P. (2017). Incidence, Risk Factors and Outcome of Pre-engraftment Gram-Negative Bacteremia after Allogeneic and Autologous Hematopoietic Stem Cell Transplantation: An Italian Prospective Multicenter Survey. Clinical Infectious Diseases, 65, 1884-1896. https://doi.org/10.1093/cid/cix690

@article{76ebc47d26094ce68f89f49a14a80699,

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

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.",

keywords = "Adolescent, Adult, Age Factors, Aged, Bacteremia, Child, Child, Preschool, Drug Resistance, Multiple, Bacterial, Escherichia coli, Female, Gram negative bacteremia, Gram-Negative Bacteria, Gram-Negative Bacterial Infections, Hematopoietic Stem Cell Transplantation, Humans, Incidence, Infant, Italy, Male, Middle Aged, Prospective Studies, Risk Factors, Transplantation Conditioning, Transplantation, Autologous, Transplantation, Homologous, Young Adult, epidemiology, multidrug resistance, stem cell transplant, survival, Adolescent, Adult, Age Factors, Aged, Bacteremia, Child, Child, Preschool, Drug Resistance, Multiple, Bacterial, Escherichia coli, Female, Gram negative bacteremia, Gram-Negative Bacteria, Gram-Negative Bacterial Infections, Hematopoietic Stem Cell Transplantation, Humans, Incidence, Infant, Italy, Male, Middle Aged, Prospective Studies, Risk Factors, Transplantation Conditioning, Transplantation, Autologous, Transplantation, Homologous, Young Adult, epidemiology, multidrug resistance, stem cell transplant, survival",

author = "Corrado Girmenia and Alice Bertaina and Alfonso Piciocchi and Katia Perruccio and Alessandra Algarotti and Alessandro Busca and Chiara Cattaneo and Raiola, {Anna Maria} and Stefano Guidi and Iori, {Anna Paola} and Anna Candoni and Giuseppe Irrera and Giuseppe Milone and Giampaolo Marcacci and Rosanna Scim{\`e} and Maurizio Musso and Laura Cudillo and Simona Sica and Luca Castagna and Luigi Castagna and Paolo Corradini and Francesco Marchesi and Domenico Pastore and Alessandrino, {Emilio Paolo} and Claudio Annaloro and Fabio Ciceri and Stella Santarone and Luca Nassi and Claudio Farina and Claudio Viscoli and Rossolini, {Gian Maria} and Francesca Bonifazi and Alessandro Rambaldi and Saveria Capria and Angela Mastronuzzi and Daria Pagliara and Paola Bernaschi and Lucia Amico and Alessandra Carotti and Antonella Mencacci and Benedetto Bruno and Brunella Bruno and Cristina Costa and Angela Passi and Giuseppe Ravizzola and Emanuele Angelucci and Anna Marchese and Marchese, {Alessandra Maria} and Patrizia Pecile and Giovanna Ventura and Giulio Ventura and Renato Fanin and Claudio Scarparo and Angelo Barbaro and Salvatore Leotta and Leotta, {Salvatore Nuccio} and Marchese, {Anna Elisa} and Cristina Becchimanzi and Daniela Donnarumma and Stefania Tringali and Baldi, {Maria Teresa} and Renato Scalone and Alessandra Picardi and William Arcese and Carla Fontana and Fontana, {Cecilia Alejandra} and Sabrina Giammarco and {Spanu Pennestri}, Teresa and Roberto Crocchiolo and Erminia Casari and Alberto Mussetti and Eutilia Conte and Eliana Conte and Fabrizio Ensoli and Giuseppe Miragliotta and Piero Marone and Milena Arghittu and Raffaella Greco and Alessandra Forcina and Paola Chichero and {Di Bartolomeo}, Paolo and Paolo Fazii and Vesselina Kroumova and Nunzia Decembrino and Marco Zecca and Giovanni Pisapia and Giulia Palazzo and Edoardo Lanino and Maura Faraci and Elio Castagnola and Roberto Bandettini and Rocco Pastano and Simona Sammassimo and Rita Passerini and Stefani, {Piero Maria} and Filippo Gherlinzoni and Roberto Rigoli and Lucia Prezioso and Benedetta Camb{\`o} and Adriana Calderaro and Carella, {Angelo Michele} and Nicola Cascavilla and Labonia, {Maria Teresa} and Ivana Celeghini and Nicola Mordini and Federica Piana and Adriana Vacca and Marco Sanna and Sanna, {Maria Maddalena} and Giovanni Podda and Corsetti, {Maria Teresa} and Andrea Rocchetti and Daniela Cilloni and {De Gobbi}, Marco and Ornella Bianco and Franca Fagioli and Francesca Carraro and {De Intinis}, Gianfranco and Alessandro Severino and Anna Proia and Proia, {Anna Silvia} and Gabriella Parisi and Daniele Vallisa and Massimo Confalonieri and Marco Confalonieri and Domenico Russo and Michele Malagola and Piero Galieni and Sadia Falcioni and Valeria Travaglini and Roberto Raimondi and Raimondi, {Maria Rosa} and Carlo Borghero and Giacomina Pavan and Giuseppe Pavan and Arcangelo Prete and Tamara Belotti and Simone Ambretti and Manuela Imola and Mianulli, {Anna Maria} and Pedna, {Maria Federica} and Simone Cesaro and {Lo Cascio}, Giuliana and Antonella Ferrari and Monica Piedimonte and Iolanda Santino and Monica Calandrelli and Attilio Olivieri and Alessandra Olivieri and Francesca Orecchioni and Milena Mirabile and Riccardo Centurioni and Luciana Gironacci and Daniela Caravelli and Susanna Gallo and {De Filippi}, Marco and Luca Cupelli and Teresa Dentamaro and Silvana Falco and Eugenio, {Ospedale S} and Serena Marotta and Antonio Risitano and Dora Lula and Pellegrino Musto and Giuseppe Pietrantuono and Antonio Traficante and Elisabetta Cerchiara and Tirindelli, {Maria Cristina} and Giordano Dicuonzo and Anna Chierichini and Barbara Anaclerico and Paola Placanica",

year = "2017",

doi = "10.1093/cid/cix690",

language = "English",

volume = "65",

pages = "1884--1896",

journal = "Clinical Infectious Diseases",

issn = "1058-4838",

publisher = "Oxford University Press",

}

Girmenia, C, Bertaina, A, Piciocchi, A, Perruccio, K, Algarotti, A, Busca, A, Cattaneo, C, Raiola, AM, Guidi, S, Iori, AP, Candoni, A, Irrera, G, Milone, G, Marcacci, G, Scimè, R, Musso, M, Cudillo, L, Sica, S, Castagna, L, Castagna, L, Corradini, P, Marchesi, F, Pastore, D, Alessandrino, EP, Annaloro, C, Ciceri, F, Santarone, S, Nassi, L, Farina, C, Viscoli, C, Rossolini, GM, Bonifazi, F, Rambaldi, A, Capria, S, Mastronuzzi, A, Pagliara, D, Bernaschi, P, Amico, L, Carotti, A, Mencacci, A, Bruno, B, Bruno, B, Costa, C, Passi, A, Ravizzola, G, Angelucci, E, Marchese, A, Marchese, AM, Pecile, P, Ventura, G, Ventura, G, Fanin, R, Scarparo, C, Barbaro, A, Leotta, S, Leotta, SN, Marchese, AE, Becchimanzi, C, Donnarumma, D, Tringali, S, Baldi, MT, Scalone, R, Picardi, A, Arcese, W, Fontana, C, Fontana, CA, Giammarco, S, Spanu Pennestri, T, Crocchiolo, R, Casari, E, Mussetti, A, Conte, E, Conte, E, 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, G, Palazzo, G, Lanino, E, Faraci, M, Castagnola, E, Bandettini, R, Pastano, R, Sammassimo, S, Passerini, R, Stefani, PM, Gherlinzoni, F, Rigoli, R, Prezioso, L, Cambò, B, Calderaro, A, Carella, AM, Cascavilla, N, Labonia, MT, Celeghini, I, Mordini, N, Piana, F, Vacca, A, Sanna, M, Sanna, MM, Podda, G, Corsetti, MT, Rocchetti, A, Cilloni, D, De Gobbi, M, Bianco, O, Fagioli, F, Carraro, F, De Intinis, G, Severino, A, Proia, A, Proia, AS, Parisi, G, Vallisa, D, Confalonieri, M, Confalonieri, M, Russo, D, Malagola, M, Galieni, P, Falcioni, S, Travaglini, V, Raimondi, R, Raimondi, MR, Borghero, C, Pavan, G, Pavan, G, Prete, A, Belotti, T, Ambretti, S, Imola, M, Mianulli, AM, Pedna, MF, Cesaro, S, Lo Cascio, G, Ferrari, A, Piedimonte, M, Santino, I, Calandrelli, M, Olivieri, A, Olivieri, A, Orecchioni, F, Mirabile, M, Centurioni, R, Gironacci, L, Caravelli, D, Gallo, S, De Filippi, M, Cupelli, L, Dentamaro, T, Falco, S, Eugenio, OS, Marotta, S, Risitano, A, Lula, D, Musto, P, Pietrantuono, G, Traficante, A, Cerchiara, E, Tirindelli, MC, Dicuonzo, G, Chierichini, A, Anaclerico, B & Placanica, P 2017, 'Incidence, Risk Factors and Outcome of Pre-engraftment Gram-Negative Bacteremia after Allogeneic and Autologous Hematopoietic Stem Cell Transplantation: An Italian Prospective Multicenter Survey', Clinical Infectious Diseases, vol. 65, pagg. 1884-1896. https://doi.org/10.1093/cid/cix690

Incidence, Risk Factors and Outcome of Pre-engraftment Gram-Negative Bacteremia after Allogeneic and Autologous Hematopoietic Stem Cell Transplantation: An Italian Prospective Multicenter Survey. / Girmenia, Corrado; Bertaina, Alice; Piciocchi, Alfonso et al.
In: Clinical Infectious Diseases, Vol. 65, 2017, pag. 1884-1896.

Risultato della ricerca: Contributo in rivista › Articolo in rivista

TY - JOUR

T1 - Incidence, Risk Factors and Outcome of Pre-engraftment Gram-Negative Bacteremia after Allogeneic and Autologous Hematopoietic Stem Cell Transplantation: An Italian Prospective Multicenter Survey

AU - Girmenia, Corrado

AU - Bertaina, Alice

AU - Piciocchi, Alfonso

AU - Perruccio, Katia

AU - Algarotti, Alessandra

AU - Busca, Alessandro

AU - Cattaneo, Chiara

AU - Raiola, Anna Maria

AU - Guidi, Stefano

AU - Iori, Anna Paola

AU - Candoni, Anna

AU - Irrera, Giuseppe

AU - Milone, Giuseppe

AU - Marcacci, Giampaolo

AU - Scimè, Rosanna

AU - Musso, Maurizio

AU - Cudillo, Laura

AU - Sica, Simona

AU - Castagna, Luca

AU - Castagna, Luigi

AU - Corradini, Paolo

AU - Marchesi, Francesco

AU - Pastore, Domenico

AU - Alessandrino, Emilio Paolo

AU - Annaloro, Claudio

AU - Ciceri, Fabio

AU - Santarone, Stella

AU - Nassi, Luca

AU - Farina, Claudio

AU - Viscoli, Claudio

AU - Rossolini, Gian Maria

AU - Bonifazi, Francesca

AU - Rambaldi, Alessandro

AU - Capria, Saveria

AU - Mastronuzzi, Angela

AU - Pagliara, Daria

AU - Bernaschi, Paola

AU - Amico, Lucia

AU - Carotti, Alessandra

AU - Mencacci, Antonella

AU - Bruno, Benedetto

AU - Bruno, Brunella

AU - Costa, Cristina

AU - Passi, Angela

AU - Ravizzola, Giuseppe

AU - Angelucci, Emanuele

AU - Marchese, Anna

AU - Marchese, Alessandra Maria

AU - Pecile, Patrizia

AU - Ventura, Giovanna

AU - Ventura, Giulio

AU - Fanin, Renato

AU - Scarparo, Claudio

AU - Barbaro, Angelo

AU - Leotta, Salvatore

AU - Leotta, Salvatore Nuccio

AU - Marchese, Anna Elisa

AU - Becchimanzi, Cristina

AU - Donnarumma, Daniela

AU - Tringali, Stefania

AU - Baldi, Maria Teresa

AU - Scalone, Renato

AU - Picardi, Alessandra

AU - Arcese, William

AU - Fontana, Carla

AU - Fontana, Cecilia Alejandra

AU - Giammarco, Sabrina

AU - Spanu Pennestri, Teresa

AU - Crocchiolo, Roberto

AU - Casari, Erminia

AU - Mussetti, Alberto

AU - Conte, Eutilia

AU - Conte, Eliana

AU - Ensoli, Fabrizio

AU - Miragliotta, Giuseppe

AU - Marone, Piero

AU - Arghittu, Milena

AU - Greco, Raffaella

AU - Forcina, Alessandra

AU - Chichero, Paola

AU - Di Bartolomeo, Paolo

AU - Fazii, Paolo

AU - Kroumova, Vesselina

AU - Decembrino, Nunzia

AU - Zecca, Marco

AU - Pisapia, Giovanni

AU - Palazzo, Giulia

AU - Lanino, Edoardo

AU - Faraci, Maura

AU - Castagnola, Elio

AU - Bandettini, Roberto

AU - Pastano, Rocco

AU - Sammassimo, Simona

AU - Passerini, Rita

AU - Stefani, Piero Maria

AU - Gherlinzoni, Filippo

AU - Rigoli, Roberto

AU - Prezioso, Lucia

AU - Cambò, Benedetta

AU - Calderaro, Adriana

AU - Carella, Angelo Michele

AU - Cascavilla, Nicola

AU - Labonia, Maria Teresa

AU - Celeghini, Ivana

AU - Mordini, Nicola

AU - Piana, Federica

AU - Vacca, Adriana

AU - Sanna, Marco

AU - Sanna, Maria Maddalena

AU - Podda, Giovanni

AU - Corsetti, Maria Teresa

AU - Rocchetti, Andrea

AU - Cilloni, Daniela

AU - De Gobbi, Marco

AU - Bianco, Ornella

AU - Fagioli, Franca

AU - Carraro, Francesca

AU - De Intinis, Gianfranco

AU - Severino, Alessandro

AU - Proia, Anna

AU - Proia, Anna Silvia

AU - Parisi, Gabriella

AU - Vallisa, Daniele

AU - Confalonieri, Massimo

AU - Confalonieri, Marco

AU - Russo, Domenico

AU - Malagola, Michele

AU - Galieni, Piero

AU - Falcioni, Sadia

AU - Travaglini, Valeria

AU - Raimondi, Roberto

AU - Raimondi, Maria Rosa

AU - Borghero, Carlo

AU - Pavan, Giacomina

AU - Pavan, Giuseppe

AU - Prete, Arcangelo

AU - Belotti, Tamara

AU - Ambretti, Simone

AU - Imola, Manuela

AU - Mianulli, Anna Maria

AU - Pedna, Maria Federica

AU - Cesaro, Simone

AU - Lo Cascio, Giuliana

AU - Ferrari, Antonella

AU - Piedimonte, Monica

AU - Santino, Iolanda

AU - Calandrelli, Monica

AU - Olivieri, Attilio

AU - Olivieri, Alessandra

AU - Orecchioni, Francesca

AU - Mirabile, Milena

AU - Centurioni, Riccardo

AU - Gironacci, Luciana

AU - Caravelli, Daniela

AU - Gallo, Susanna

AU - De Filippi, Marco

AU - Cupelli, Luca

AU - Dentamaro, Teresa

AU - Falco, Silvana

AU - Eugenio, Ospedale S

AU - Marotta, Serena

AU - Risitano, Antonio

AU - Lula, Dora

AU - Musto, Pellegrino

AU - Pietrantuono, Giuseppe

AU - Traficante, Antonio

AU - Cerchiara, Elisabetta

AU - Tirindelli, Maria Cristina

AU - Dicuonzo, Giordano

AU - Chierichini, Anna

AU - Anaclerico, Barbara

AU - Placanica, Paola

PY - 2017

Y1 - 2017

N2 - 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.

AB - 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.

KW - Adolescent

KW - Adult

KW - Age Factors

KW - Aged

KW - Bacteremia

KW - Child

KW - Child, Preschool

KW - Drug Resistance, Multiple, Bacterial

KW - Escherichia coli

KW - Female

KW - Gram negative bacteremia

KW - Gram-Negative Bacteria

KW - Gram-Negative Bacterial Infections

KW - Hematopoietic Stem Cell Transplantation

KW - Humans

KW - Incidence

KW - Infant

KW - Italy

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Risk Factors

KW - Transplantation Conditioning

KW - Transplantation, Autologous

KW - Transplantation, Homologous

KW - Young Adult

KW - epidemiology

KW - multidrug resistance

KW - stem cell transplant

KW - survival

KW - Adolescent

KW - Adult

KW - Age Factors

KW - Aged

KW - Bacteremia

KW - Child

KW - Child, Preschool

KW - Drug Resistance, Multiple, Bacterial

KW - Escherichia coli

KW - Female

KW - Gram negative bacteremia

KW - Gram-Negative Bacteria

KW - Gram-Negative Bacterial Infections

KW - Hematopoietic Stem Cell Transplantation

KW - Humans

KW - Incidence

KW - Infant

KW - Italy

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Risk Factors

KW - Transplantation Conditioning

KW - Transplantation, Autologous

KW - Transplantation, Homologous

KW - Young Adult

KW - epidemiology

KW - multidrug resistance

KW - stem cell transplant

KW - survival

UR - http://hdl.handle.net/10807/170707

U2 - 10.1093/cid/cix690

DO - 10.1093/cid/cix690

M3 - Article

SN - 1058-4838

VL - 65

SP - 1884

EP - 1896

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

ER -

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

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