1. Is surveillance for colonization of carbapenem-resistant gram-negative bacteria important in adult bone marrow transplantation units?
- Author
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Demiraslan H, Cevahir F, Berk E, Metan G, Cetin M, and Alp E
- Subjects
- Adolescent, Adult, Aged, Carrier State diagnosis, Carrier State epidemiology, Carrier State microbiology, Cross Infection epidemiology, Female, Gram-Negative Bacteria isolation & purification, Gram-Negative Bacterial Infections drug therapy, Gram-Negative Bacterial Infections epidemiology, Gram-Negative Bacterial Infections microbiology, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Young Adult, Bacterial Proteins metabolism, Bone Marrow Transplantation, Cross Infection prevention & control, Epidemiological Monitoring, Gram-Negative Bacteria enzymology, Gram-Negative Bacterial Infections diagnosis, Infection Control methods, beta-Lactamases metabolism
- Abstract
Background: The aim of this study was to investigate the rate of carbapenem-resistant gram-negative bacilli (CRGNB) colonization and to analyze the risk factors associated with CRGNB colonization., Methods: This prospective study was conducted in adult patients hospitalized in hematopoietic stem cell transplantation (HSCT) units over a period of 8 months. Rectal swab samples were obtained from each participant every Monday, and patients CRGNB positive on admission were excluded., Results: Of 185 participants, the median age was 47 years, and 59.5% were men. CRGNB colonization was detected in 21 (11.4%) patients. The most commonly isolated CRGNB were Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Multivariate analysis revealed that busulfan use (11.9 times), fludarabine use (6.4 times), transfer from another hospital (7.8 times), transfer between units (9.3 times), and central venous catheterization (5.1 times) were risk factors for CRGNB colonization. During the study period, febrile neutropenia (FN) developed in 9 (56.2%) of the 21 colonized patients, and 1 patient died., Conclusions: Screening of patients for CRGNB colonization may have a role in preventing the spread of CRGNB. However, the empirical antimicrobial treatment for FN in patients with CRGNB colonization did not change, and their mortality rates were similar., (Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)
- Published
- 2017
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