Effectiveness of surveillance cultures for high priority multidrug-resistant bacteria in hematopoietic stem cell transplant units

Mendes, Elisa Donalísio Teixeira; Salomão, Matias Chiarastelli; Tomichi, Lísia Moura; Oliveira, Maura Salaroli de; Graca, M; Rossi, Flávia; Sapadao, Fernanda; Guimarães, Thaís; Rocha, Vanderson; Costa, Sílvia Figueiredo

doi:10.1590/s1678-9946202163077

Cited by 4 publications

(4 citation statements)

References 22 publications

(30 reference statements)

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“…Studies by Mendes et al and Sadowska-Klasa et al have shown an association between pre-colonization of the gut by P. aeruginosa resistant to carbapenems (CRPA) and bloodstream infection caused by the same strains in patients undergoing HSCT (hematopoietic stem cell transplant). The incidence of MDR bacteremia is higher in patients with MDR colonization than in non-colonized patients [21,22]. P. aeruginosa is not a common member of the gut microbiota in healthy people.…”

Section: P Aeruginosa Colonizationmentioning

confidence: 98%

“…Patients colonized/infected by the most dangerous resistant strains are isolated in single rooms depending on the availability of individual rooms in the facility [89]. Moreover, knowledge of the colonizing microorganism can be helpful in guiding the empirical antibiotic therapy [21]. Unfortunately, although surveillance stool screening (SSS) can be useful to identify hematological patients (HSCT recipients) with intestinal colonization by MDR Enterobacterales, in the case of P. aeruginosa, SSS is not highly effective because the intestinal tract is not the only possible source of infection in this group of patients [83].…”

Section: Prevention Of P Aeruginosa Infection In Cancer Patientsmentioning

confidence: 99%

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Pseudomonas aeruginosa Infections in Cancer Patients

et al. 2022

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Pseudomonas aeruginosa (P. aeruginosa) is one of the most frequent opportunistic microorganisms causing infections in oncological patients, especially those with neutropenia. Through its ability to adapt to difficult environmental conditions and high intrinsic resistance to antibiotics, it successfully adapts and survives in the hospital environment, causing sporadic infections and outbreaks. It produces a variety of virulence factors that damage host cells, evade host immune responses, and permit colonization and infections of hospitalized patients, who usually develop blood stream, respiratory, urinary tract and skin infections. The wide intrinsic and the increasing acquired resistance of P. aeruginosa to antibiotics make the treatment of infections caused by this microorganism a growing challenge. Although novel antibiotics expand the arsenal of antipseudomonal drugs, they do not show activity against all strains, e.g., MBL (metalo-β-lactamase) producers. Moreover, resistance to novel antibiotics has already emerged. Consequently, preventive methods such as limiting the transmission of resistant strains, active surveillance screening for MDR (multidrug-resistant) strains colonization, microbiological diagnostics, antimicrobial stewardship and antibiotic prophylaxis are of particular importance in cancer patients. Unfortunately, surveillance screening in the case of P. aeruginosa is not highly effective, and a fluoroquinolone prophylaxis in the era of increasing resistance to antibiotics is controversial.

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Section: P Aeruginosa Colonizationmentioning

confidence: 98%

Section: Prevention Of P Aeruginosa Infection In Cancer Patientsmentioning

confidence: 99%

Pseudomonas aeruginosa Infections in Cancer Patients

et al. 2022

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“…Nevertheless, bad prescription habits are also very present like in all other Latin American countries, and many hospitals suffer from multi-resistant bacteria which differ between two hospitals even closely within the same city. 75 A few of them established special units driven by microbiologists who monitor the situation and try to identify multi-resistance.…”

Section: Resultsmentioning

confidence: 99%

Emerging Antimicrobial Drug Resistance in Africa and Latin America: Search for Reasons

Hoellein¹,

Kaale²,

Mwalwisi³

et al. 2022

RMHP

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“…12,13 Despite major advances in the management of post-transplant outcomes, the incidence ranges from 13-46% and 5-10% among allogeneic HSCT, in which patients receive progenitor cells from the donor 13,14 and autologous HSCT, in which the patient receives their own progenitor cells, 15 respectively, with a mortality rate of 32.7%. 16 Although active surveillance strategies to detect the colonization state of HSCT recipients are important tools for controlling and preventing the spread of MDRO within hospital settings and may be useful in guiding empirical therapy for post-transplantation neutropenia, their impact on patient outcome and cost-effectiveness remains controversial, 17 particularly in developing countries where MDRO is endemic. Accordingly, this study aimed to evaluate the effect of pretransplant screening for high-priority MDRO and relevant viruses on the outcome of pre-engraftment infections.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Pre-Transplant Screening for High-Priority Multidrug-Resistant Pathogens on Pre-Engraftment Infections After Hematopoietic Stem Cell Transplantation

Kamel,

Abdalla,

Al Ali

et al. 2024

IDR

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Owing to the rising incidence of multidrug-resistant organisms (MDRO) and the high mortality rates associated with such bacterial infections post-hematopoietic stem cell transplantation (HSCT), we investigated the MDRO colonization rate prior to transplantation using an active surveillance approach and determined its impact on subsequent infection during the pre-engraftment period. Methods: A single-center observational study was conducted, and surveillance cultures from multiple body sites, including the rectum, nasal cavity, and groin, were performed at admission to determine MDRO colonization. Serological tests were used to detect certain viruses and toxoplasmosis before HSCT. Results: In the pre-transplant setting, 59 MDRO were recovered from the 40 HSCT recipients. Of the 59 isolates recovered from one or more body sites, 29 were positive for methicillin-resistant Staphylococcus aureus (MRSA), 7 for carbapenem-resistant Enterobacterales (CRE), and 23 were positive for extended-spectrum β-lactamase (ESBLs). Serological assessment before HSCT revealed active or reactivation of latent infection with cytomegalovirus (7.5%), Epstein-Barr virus (EBV; 5%), and Toxoplasma gondii (2.5%) among HSCT patients. In terms of factors associated with pre-engraftment infections, the type of transplant (p=0.04) was statistically significant, whereas other factors, such as age, sex, and underlying conditions, were not. In post-transplant settings, bloodstream infections (BSIs) were documented in 2 allogeneic HSCT patients (5%), and the isolated microorganisms were ESBLproducing E. coli and non-MDR Acinetobacter baumannii. Conclusion: Active screening cultures are a helpful tool for identifying patients colonized by MDRO or relevant viruses before HSCT, and for predicting those at risk of developing subsequent pre-engraftment infections. Additionally, active screening may aid in predicting those who are likely to develop subsequent pre-engraftment infections Our findings highlight the importance of pretransplant screening for high-priority multidrug-resistant pathogens and the application of infection control interventions after HSCT.

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Effectiveness of surveillance cultures for high priority multidrug-resistant bacteria in hematopoietic stem cell transplant units

Cited by 4 publications

References 22 publications

Pseudomonas aeruginosa Infections in Cancer Patients

Pseudomonas aeruginosa Infections in Cancer Patients

Emerging Antimicrobial Drug Resistance in Africa and Latin America: Search for Reasons

Effectiveness of Pre-Transplant Screening for High-Priority Multidrug-Resistant Pathogens on Pre-Engraftment Infections After Hematopoietic Stem Cell Transplantation

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