Bacteremia in Haematopoietic Stem Cell Recipients Receiving Fluoroquinolone Prophylaxis: Incidence, Resistance and Risk Factors

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ERYILMAZ E., İZCİ F., TÜRE YÜCE Z., SAĞIROĞLU P., KAYNAR L., ULU KILIÇ A.

INFECTION AND CHEMOTHERAPY, cilt.54, 2022 (ESCI) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 54
  • Basım Tarihi: 2022
  • Doi Numarası: 10.3947/ic.2022.0005
  • Dergi Adı: INFECTION AND CHEMOTHERAPY
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Academic Search Premier, CAB Abstracts, EMBASE, Veterinary Science Database, Directory of Open Access Journals
  • Anahtar Kelimeler: Fluoroquinolone, Hematopoietic stem cell recipients, Bacteremia, BLOOD-STREAM INFECTIONS, SINGLE-CENTER, ANTIMICROBIAL RESISTANCE, NEUTROPENIC PATIENTS, FEBRILE NEUTROPENIA, TRANSPLANTATION, MALIGNANCY, EXPERIENCE, IMPACT
  • Erciyes Üniversitesi Adresli: Evet

Özet

Background: Bacteremia is a common complication in hematopoietic stem cell transplant (HSCT) recipients. Prophylactic fluoroquinolone is recommended and used in these individuals. Breakthrough infections can occur with fluoroquinolone-resistant strains. We aimed to identify the incidence, resistance, and risk factors for bacteremia in HSCT recipients receiving fluoroquinolone prophylaxis.Materials and Methods: This retrospective study was performed on patients who received fluoroquinolone prophylaxis and underwent autologous and allogeneic HSCT between 2015 and 2019. The incidence of bacteremia, comorbidity, treatment, and invasive procedures was compared in these patients with and without bacteremia.Results: There were 553 patients included in the study, 68 (12.3%) had bacteremia. The incidence of bacteremia is 8.2% of autologous HSCT recipients and 18.4% of allogeneic HSCT recipients. The significant risk factors associated with bacteremia were steroid -using (odds ratio [OR]:13.83, 95% confidence interval [CI]: 2.88 -66.40), higher Charlson Comorbidity Index (CCI)-mean (OR: 1.57, 95% CI: 1.15 -2.16), diabetes mellitus (OR: 4.29, 95% CI: 1.11 -16.48) in autologous HSCT, steroid-using (OR: 6.84, 95% CI: 1.44 -32.33), longer duration of neutropenia (OR: 1.05, 95% CI: 1.01 -1.09) using central venous catheter (OR: 7.81, 95% CI: 1.00 -61.23) in allogeneic HSCT. Seventy-three pathogens were isolated from a total of 68 bacteremia episodes. The most commonly occurring agents were Escherichia coli, Klebsiella pneumoniae and Enterococcus spp. Resistance to fluoroquinolones was 87.2%, 70.0% and 60.0% among these strains, respectively.Conclusion: High CCI, diabetes mellitus, use of steroids and long-term neutropenia and use of central venous catheters were significantly associated with the breakthrough bacteremia in HSCT recipients receiving fluoroquinolone prophylaxis. Fluoroquinolone prophylaxis may reduce the incidence of bacteremia but may select strains resistant to fluoroquinolone.