Assessment of colonization and infection epidemiology in patients undergoing autologous hematopoietic stem cell transplantation: a single-center study

Abstract

Introduction: Infections are one of the main causes of early death after autologous hematopoietic stem cell transplantation (auto-HSCT). Material and methods: We present a single-center retrospective analysis of colonization and infection epidemiology in 115 patients with median age 63 years (range 21–72), who underwent auto-HSCT in 2017 or 2018 in the course of multiple myeloma [79.1% (n = 91)], Hodgkin lymphoma [18.3% (n = 21)] and non-Hodgkin lymphoma [2.6% (n = 3)]. Results: Colonization was observed in 40.9% of patients before auto-HSCT, the most common location being the urinary tract — 54.3%. Multi-drug resistant bacteria (MDR) accounted for 20.9% of positive colonization cultures before auto-HSCT. In the post-transplantation period, infections occurred in 77.4% of patients after auto-HSCT. Bacteremia was observed in 43.5% of patients and it was mostly caused by methicillin-resistant coagulase-negative Staphylococcus epidermidis (MRCNSE) — 27.6%. Infection of the skin near the central vascular catheter was found in 18.3% of patients, urinary tract infections in 11.3%, and gastrointestinal infections in 20.9%. MDR pathogens accounted for 65.2%. The most common of these was methicillin-resistant coagulase-negative Staphylococcus (MRCNS) — 73.9%. Fungal and viral infections were reported in 21.7% and 7%, respectively. The median duration of empirical and targeted antibiotic therapy was 5 (range 1–20) and 7 (range 4–31) days, respectively. Death due to septic shock occurred in 2/115 (1.7%) patients during the neutropenia period. Conclusions: Evaluation of the epidemiology of colonization and infection in patients undergoing auto-HSCT can be an effective tool in providing control and therapy for infections in HSCT recipients. Such knowledge is also essential in monitoring potential pathogen transmission and helping to improve local infection management standards.