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Bloodstream Infecti...
Bloodstream Infections and Outcomes Following Allogeneic Hematopoietic Cell Transplantation : A Single-Center Study
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Carreira, Abel Santos (author)
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Salas, Maria Queralt (author)
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- Remberger, Mats, Professor, 1955- (author)
- Uppsala universitet,Hematologi
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Basso, Igor Novitzky (author)
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Law, Arjun Datt (author)
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Lam, Wilson (author)
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Pasic, Ivan (author)
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Kim, Dennis (author)
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Michelis, Fotios V. (author)
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Viswabandya, Auro (author)
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Gerbitz, Armin (author)
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Lipton, Jeffrey Howard (author)
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Husain, Shahid (author)
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Kumar, Rajat (author)
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- Mattsson, Jonas (author)
- Karolinska Institutet
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(creator_code:org_t)
- Elsevier, 2022
- 2022
- English.
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In: Transplantation and Cellular Therapy. - : Elsevier. - 2666-6375 .- 2666-6367. ; 28:1, s. 50.e1-50.e8
- Related links:
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https://doi.org/10.1...
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https://urn.kb.se/re...
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Abstract
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- This study investigated the single-center incidence and risk factors for bloodstream infections (BSIs) in 651 adults who underwent allogeneic hematopoietic cell transplantation (alloHCT) between 2015 and 2019 and explored the impact of these BSIs on post-transplantation outcomes. Antibiotic prophylaxis with ciprofloxacin was given during the aplastic phase. Overall, the median patient age was 57 years, 79.7% of patients received an alternative donor graft, and 68.7% received post-transplantation cyclophosphamide (PTCy) as part of their graft-versus-host disease (GVHD) prophylaxis. Of the 651 patients, 358 (55.0%) had at least 1 episode of BSI, and the overall mortality rate secondary to this complication was 7.5% (12.6% among those diagnosed with at least 1 episode of BSI). BSI was more often diagnosed during the first 30 days (58.7%), and gram-positive bacteria were the most prevalent microorganisms isolated during the entire post-transplantation follow-up (62%). A high Disease Risk Index (hazard ratio [HR], 1.47; P < .029) and receipt of PTCy-based GVHD prophylaxis (HR, 3.33; P < .001) were identified as risk factors for BSI. Additionally, univariate analysis showed that patients diagnosed with a BSI during post-transplantation follow-up had worse overall survival (HR, 2.48; P < .001) and higher nonrelapse mortality (HR, 2.68; P < .001) than those without BSI. In conclusion, alloHCT recipients with a BSI had a higher risk of mortality compared with those who did not develop BSI. The inclusion of PTCy as part of GVHD prophylaxis was identified as an independent risk factor for BSI during early post-transplantation follow-up. Single-center analyses focused on reporting the incidence and risk factors for BSI highlight the need for active implementation of preemptive strategies to decrease BSI incidence in the alloHCT setting.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Hematologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Hematology (hsv//eng)
Keyword
- Bloodstream infection
- Allogeneic hematopoietic cell transplantation
- Outcome
- Nonrelapse mortality
- Klinisk immunologi
- Clinical Immunology
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Carreira, Abel S ...
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Salas, Maria Que ...
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Remberger, Mats, ...
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Basso, Igor Novi ...
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Law, Arjun Datt
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Lam, Wilson
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Pasic, Ivan
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Kim, Dennis
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Michelis, Fotios ...
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Viswabandya, Aur ...
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Gerbitz, Armin
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Lipton, Jeffrey ...
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Husain, Shahid
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Kumar, Rajat
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Mattsson, Jonas
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Hematology
- Articles in the publication
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Transplantation ...
- By the university
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Uppsala University
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Karolinska Institutet