Original scientific paper

BLOODSTREAM INFECTIONS AFTER LIVER AND HEMATOPOIETIC STEM CELL TRANSPLANTATION

ZINAIDA PERIĆ ; Clinical Department of Medicine, Merkur University Hospital and 4School of Medicine, University of Zagreb, Zagreb, Croatia
ARJANA TAMBIĆ-ANDRAŠEVIĆ ; Department of Clinical Microbiology, Dr Fran Mihaljević University Hospital for Infectious Diseases, and School of Medicine, University of Zagreb, Zagreb, Croatia
ANA MRZLJAK ; Clinical Department of Medicine, Merkur University Hospital and School of Medicine, University of Zagreb, Zagreb, Croatia
IVA KOŠUTA ; Clinical Department of Medicine, Merkur University Hospital and School of Medicine, University of Zagreb, Zagreb, Croatia
VIŠNJA KOVAČEVIĆ ; Department of Clinical Microbiology, Dr Fran Mihaljević University Hospital for Infectious Diseases, Zagreb, Croatia
DENIS GUŠTIN ; Department of Anesthesiology and Intensive Care, Merkur University Hospital, Zagreb, Croatia
RADOVAN VRHOVAC ; Clinical Department of Medicine, Merkur University Hospital and School of Medicine, University of Zagreb, Zagreb, Croatia

Abstract

The aim of this retrospective study was to evaluate and compare the incidence, timing and etiology of bloodstream infections (BSIs) in patients treated with liver- (LT) or hematopoietic stem cell transplantation (HSCT) in a single institution. We evaluated 280 consecutive transplantations over a period of 34 months. Our results demonstrated 84 episodes of BSIs (47 in LT patients and 37 in HSCT patients) at a median of 28 days post-transplantation. Relative incidence of 34.6 and 29.4 BSI episodes per 100 LT and HSCT patients, respectively, did not differ significantly between the two groups (p=0.52). BSIs in HSCT patients occurred significantly earlier (p=0.003) than in LT patients. The recently described reemergence of gram-negative (GN) pathogens as causative agents of BSIs in these patients was confirmed: GN bacilli were the predominant isolates in the LT group, responsible for 58.5% of BSIs and a very frequent (39%) cause of BSIs in the HSCT group. A higher incidence of resistant enterobacteriaceae producing extended spectrum beta-lactamases was found in isolates from LT patients compared to HSCT patients. In both groups, Pseudomonas aeruginosa was the most difficult to treat organism, with 57% of these isolates in LT patients and 44% in HSCT patients being resistant to carbapenems. To conclude, BSIs were confirmed to be important infectious complications of both LT and HSCT. Surveillance and analysis of bacteria causing bloodstream and other serious infections in transplanted patients remain the main prerequisites for planning interventions regarding prevention and treatment of infections in these patients

Keywords

sepsis; liver transplantation; hematopoietic stem cell transplantation; antimicrobial resistance

Hrčak ID:

104158

URI

https://hrcak.srce.hr/104158

Publication date:

20.6.2013.

Article data in other languages: croatian

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