Impact of fluoroquinolone administration and gut mucosal colonization on the risk of pre-engraftment bloodstream infections after allogeneic hematopoietic cell transplantation.

Publisher: Taylor & Francis Country of Publication: United States NLM ID: 9007422 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1029-2403 (Electronic) Linking ISSN: 10268022 NLM ISO Abbreviation: Leuk Lymphoma Subsets: MEDLINE

Publication: [Philadelphia, PA] : Taylor & Francis
Original Publication: Chur ; New York : London, UK : Harwood Academic Publishers ; Distributed by STBS, 1989-

Fluoroquinolones*/administration & dosage ; Fluoroquinolones*/adverse effects ; Sepsis* ; Gram-Negative Bacterial Infections*/drug therapy ; Gram-Negative Bacteria*/drug effects ; Antibiotic Prophylaxis*; Hematopoietic Stem Cell Transplantation/adverse effects ; Anti-Bacterial Agents/administration & dosage ; Anti-Bacterial Agents/adverse effects ; Case-Control Studies ; Preoperative Period ; Retrospective Studies ; Humans ; Male ; Female ; Adolescent ; Adult ; Middle Aged ; Aged ; Treatment Outcome

Fluoroquinolones (FQ) has been used after allogeneic hematopoietic stem cell transplantation (allo-HCT) for decades. This study on 284 allo-HCT recipients aimed to analyze the impact of FQ on pre-engraftment BSI. A total of 154 patients were colonized with resistant gram-negative bacteria, and 130 patients were not. Colonized patients did not receive FQ ( n  = 147) except 7 who received FQ as sequential therapy; 98 non-colonized patients received FQ, whereas 32 did not. Gram-negative ( p  < 0.0001), and ESBL-E BSI ( p  < 0.0001) were higher in colonized patients receiving FQ. No difference was found in gram-positive BSI ( p  = 0.452). In multivariate analysis colonized patients with ( p  < 0.0001) or without FQ ( p  = 0.007), omission of FQ in non-colonized patients ( p  = 0.038), and active disease ( p  = 0.042) were associated with gram-negative BSI, whereas mismatched unrelated donor transplantations - with gram-positive BSI ( p  = 0.009). Colonized patients with FQ have a higher risk of gram-negative BSI. In non-colonized patients, FQ prophylaxis is effective approach significantly reducing gram-negative BSI risk.

Keywords: Allogeneic hematopoietic cell transplantation (allo-HCT); bloodstream infections (BSI); colonization; fluoroquinolone (FQ); pre-engraftment

0 (Fluoroquinolones)
0 (Anti-Bacterial Agents)

Date Created: 20230422 Date Completed: 20240131 Latest Revision: 20240131

20240131

10.1080/10428194.2023.2197532

37086466