Publication:
Antimicrobial Resistance in Gram-Negative Rods Causing Bacteremia in Hematopoietic Stem Cell Transplant Recipients: Intercontinental Prospective Study of the Infectious Diseases Working Party of the European Bone Marrow Transplantation Group.

cris.virtualsource.author-orcid1b65be99-ede2-4b0e-8e6d-1c720e453513
datacite.rightsopen.access
dc.contributor.authorAverbuch, Diana
dc.contributor.authorTridello, Gloria
dc.contributor.authorHoek, Jennifer
dc.contributor.authorMikulska, Malgorzata
dc.contributor.authorAkan, Hamdi
dc.contributor.authorYanez San Segundo, Lucrecia
dc.contributor.authorPabst, Thomas Niklaus
dc.contributor.authorÖzçelik, Tülay
dc.contributor.authorKlyasova, Galina
dc.contributor.authorDonnini, Irene
dc.contributor.authorWu, Depei
dc.contributor.authorGülbas, Zafer
dc.contributor.authorZuckerman, Tsila
dc.contributor.authorBotelho de Sousa, Aida
dc.contributor.authorBeguin, Yves
dc.contributor.authorXhaard, Aliénor
dc.contributor.authorBachy, Emmanuel
dc.contributor.authorLjungman, Per
dc.contributor.authorde la Camara, Rafael
dc.contributor.authorRascon, Jelena
dc.contributor.authorRuiz Camps, Isabel
dc.contributor.authorVitek, Antonin
dc.contributor.authorPatriarca, Francesca
dc.contributor.authorCudillo, Laura
dc.contributor.authorVrhovac, Radovan
dc.contributor.authorShaw, Peter J
dc.contributor.authorWolfs, Tom
dc.contributor.authorO'Brien, Tracey
dc.contributor.authorAvni, Batia
dc.contributor.authorSilling, Gerda
dc.contributor.authorAl Sabty, Firas
dc.contributor.authorGraphakos, Stelios
dc.contributor.authorSankelo, Marja
dc.contributor.authorSengeloev, Henrik
dc.contributor.authorPillai, Srinivas
dc.contributor.authorMatthes, Susanne
dc.contributor.authorMelanthiou, Frederiki
dc.contributor.authorIacobelli, Simona
dc.contributor.authorStyczynski, Jan
dc.contributor.authorEngelhard, Dan
dc.contributor.authorCesaro, Simone
dc.date.accessioned2024-10-25T13:53:20Z
dc.date.available2024-10-25T13:53:20Z
dc.date.issued2017-11-13
dc.description.abstractBackground This intercontinental study aimed to study gram-negative rod (GNR) resistance in hematopoietic stem cell transplantation (HSCT). Methods GNR bacteremias occurring during 6 months post-HSCT (February 2014-May 2015) were prospectively collected, and analyzed for rates and risk factors for resistance to fluoroquinolones, noncarbapenem anti-Pseudomonas β-lactams (noncarbapenems), carbapenems, and multidrug resistance. Results Sixty-five HSCT centers from 25 countries in Europe, Australia, and Asia reported data on 655 GNR episodes and 704 pathogens in 591 patients (Enterobacteriaceae, 73%; nonfermentative rods, 24%; and 3% others). Half of GNRs were fluoroquinolone and noncarbapenem resistant; 18.5% carbapenem resistant; 35.2% multidrug resistant. The total resistance rates were higher in allogeneic HSCT (allo-HSCT) vs autologous HSCT (auto-HSCT) patients (P < .001) but similar in community-acquired infections. Noncarbapenem resistance and multidrug resistance were higher in auto-HSCT patients in centers providing vs not providing fluoroquinolone prophylaxis (P < .01). Resistance rates were higher in southeast vs northwest Europe and similar in children and adults, excluding higher fluoroquinolone- and β-lactam/β-lactamase inhibitor resistance rates in allo-HSCT adults. Non-Klebsiella Enterobacteriaceae were rarely carbapenem resistant. Multivariable analysis revealed resistance risk factors in allo-HSCT patients: fluoroquinolone resistance: adult, prolonged neutropenia, breakthrough on fluoroquinolones; noncarbapenem resistance: hospital-acquired infection, breakthrough on noncarbapenems or other antibiotics (excluding fluoroquinolones, noncarbapenems, carbapenems), donor type; carbapenem resistance: breakthrough on carbapenem, longer hospitalization, intensive care unit, previous other antibiotic therapy; multidrug resistance: longer hospitalization, breakthrough on β-lactam/β-lactamase inhibitors, and carbapenems. Inappropriate empiric therapy and mortality were significantly more common in infections caused by resistant bacteria. Conclusions Our data question the recommendation for fluoroquinolone prophylaxis and call for reassessment of local empiric antibiotic protocols. Knowledge of pathogen-specific resistance enables early appropriate empiric therapy. Monitoring of resistance is crucial. Clinical Trials Registration NCT02257931.
dc.description.numberOfPages10
dc.description.sponsorshipUniversitätsklinik für Medizinische Onkologie
dc.identifier.doi10.7892/boris.111214
dc.identifier.pmid29020364
dc.identifier.publisherDOI10.1093/cid/cix646
dc.identifier.urihttps://boris-portal.unibe.ch/handle/20.500.12422/158323
dc.language.isoen
dc.publisherOxford University Press
dc.relation.ispartofClinical infectious diseases
dc.relation.issn1058-4838
dc.relation.organizationDCD5A442C448E17DE0405C82790C4DE2
dc.subjectantimicrobial resistance bacteremia gram-negative rods hematopoietic stem cell transplantation
dc.subject.ddc600 - Technology::610 - Medicine & health
dc.titleAntimicrobial Resistance in Gram-Negative Rods Causing Bacteremia in Hematopoietic Stem Cell Transplant Recipients: Intercontinental Prospective Study of the Infectious Diseases Working Party of the European Bone Marrow Transplantation Group.
dc.typearticle
dspace.entity.typePublication
dspace.file.typetext
oaire.citation.endPage1828
oaire.citation.issue11
oaire.citation.startPage1819
oaire.citation.volume65
oairecerif.author.affiliationUniversitätsklinik für Medizinische Onkologie
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unibe.date.licenseChanged2019-11-03 08:03:34
unibe.description.ispublishedpub
unibe.eprints.legacyId111214
unibe.journal.abbrevTitleCLIN INFECT DIS
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unibe.subtype.articlejournal

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