Clinical Analysis of Bacterial Infection Characteristics in Lymphoma Patients with High-dose Chemotherapy Combined with Autologous Hematopoietic Stem Cell Transplantation-A Single-Centered Retrospective Study
- Authors: Sun D.1, Mei D.2, Yao X.3, Rong Y.1, Wang G.1
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Affiliations:
- Department of Infectious Diseases, Peking University International Hospital
- Department of Lymphoma, Peking University International Hospital
- Department of Traditional Chinese Medicine, Peking University International Hospital
- Issue: Vol 27, No 8 (2024)
- Pages: 1149-1160
- Section: Chemistry
- URL: https://rjeid.com/1386-2073/article/view/644966
- DOI: https://doi.org/10.2174/1386207326666230915115056
- ID: 644966
Cite item
Full Text
Abstract
Background:High-dose chemotherapy combined with autologous hematopoietic stem cell transplantation (HDT/AHSCT) is used to treat lymphoma. Although AHSCT has made considerable strides and become safer, HDT-AHSCT infection continues to be a leading cause of morbidity and mortality associated with transplantation.
Objective:To characterise pathogenic bacterial infections in HDT/AHSCT-treated lymphoma patients. The prevalence of pathogenic microorganisms and the timing of foci after transplantation, along with bloodstream infection (BSI) risk factors, can help determine the need for empirical antibiotics after AHSCT.
Methods:We retrospectively analyzed 133 lymphoma patients treated by HDT/AHSCT from April 2017 to October 2021 at Peking University International Hospital, Beijing, China. We analyzed their clinical characteristics, microbiological distribution characteristics, and BSI risk factors in detail.
Results:In order, intestinal infection (56 cases), BSI (17 cases), pulmonary (12 cases), upper respiratory tract (5 cases), and perianal (4 cases) were the most common locations of infection after HDT/AHSCT. The infection sites yielded 92 putative pathogenic pathogens, with bacteria predominating (61.96%), fungi (28.26%), viruses (5.43%), and mycoplasma (4.35%). Gram-negative bacteria (GNB) strains outnumbered gram-positive bacteria (GPB) strains (73.68%). Two strains of Escherichia coli produced extended-spectrum β-lactamase (ESBL) and one strain of carbapenem-resistant enterobacteriaceae (CRE). Methicillin-resistant Staphylococcus epidermidis (MRSE) had one strain. BSI was caused by Escherichia coli (82.35%), Intestinal mucositis (23.52%), and catheter-associated infections (11.76%). Age, CD34, pretreatment regimen, antibiotic regimen, and past chemotherapeutic agent lung damage were BSI risk variables in univariate analysis. CD34 and past chemotherapeutic drug lung damage were the primary causes of BSI after HDT/AHSCT for lymphoma.
Conclusion:High-dose chemotherapy combined with autologous hematopoietic stem cell transplantation (HDT/AHSCT) is used to treat lymphoma. Although AHSCT has made considerable strides and become safer, HDT-AHSCT infection continues to be a leading cause of morbidity and mortality associated with transplantation.
About the authors
Dan-Hui Sun
Department of Infectious Diseases, Peking University International Hospital
Email: info@benthamscience.net
Di Mei
Department of Lymphoma, Peking University International Hospital
Email: info@benthamscience.net
Xiao-Qin Yao
Department of Traditional Chinese Medicine, Peking University International Hospital
Email: info@benthamscience.net
Yi-Hui Rong
Department of Infectious Diseases, Peking University International Hospital
Email: info@benthamscience.net
Gui-Qiang Wang
Department of Infectious Diseases, Peking University International Hospital
Author for correspondence.
Email: info@benthamscience.net
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