Outbreaks of infectious diseases in stem cell transplant units: a silent cause of death for patients and transplant programmes

McCann, Shaun R.; Byrne, J L; Rovira, Miquel; Shaw, Peter J.; Ribaud, Patricia; Sica, Simona; Volin, Liisa; Olavarría, Eduardo; Mackinnon, Stephen; Trabasso, Plı́nio; VanLint, M T; Ljungman, Per; Ward, Katherine N.; Browne, Paul; Gratwohl, Aloïs; Widmer, Andreas F.; Cordonnier, Catherine

doi:10.1038/sj.bmt.1704380

Cited by 61 publications

(51 citation statements)

References 37 publications

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“…Nosocomial outbreaks have been described in oncology units and BMT units, 11 and different environmental sources have been identified as reservoirs for the microbial species that are frequently responsible for invasive infections in neutropenic patients. However, the mechanisms of P. aeruginosa nosocomial transmission in haematologyoncology patients are complex and not fully elucidated.…”

Section: Discussionmentioning

confidence: 99%

Molecular epidemiological investigation of an outbreak of Pseudomonas aeruginosa infection in an SCT unit

Fanci

Bartolozzi

Sergi

et al. 2008

Bone Marrow Transplant

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Section: Discussionmentioning

confidence: 99%

Molecular epidemiological investigation of an outbreak of Pseudomonas aeruginosa infection in an SCT unit

Fanci

Bartolozzi

Sergi

et al. 2008

Bone Marrow Transplant

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“…1,2 Antibiotic cycling is among the proposed strategies to prevent antibiotic resistance. It consists of scheduled changes of antibiotic use with removal of an antibiotic from routine use and re-introduction later, alternating with other antibiotics in an attempt to maintain heterogeneous pressure over the bacterial flora of the hospital and, theoretically, prevent the emergence of resistance.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic cycling to decrease bacterial antibiotic resistance: a 5-year experience on a bone marrow transplant unit

Cadena

Taboada

Burgess

et al. 2007

Bone Marrow Transplant

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“…Sensitised by reports of epidemics in HSCT institutions, [29][30][31] we were interested to find out whether incidence and cause of infectious deaths and time of death from infections has changed over the years.…”

mentioning

confidence: 99%

Cause of death after allogeneic haematopoietic stem cell transplantation (HSCT) in early leukaemias: an EBMT analysis of lethal infectious complications and changes over calendar time

Gratwohl

Brand

Frassoni

et al. 2005

Bone Marrow Transplant

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241

178

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Summary:We analysed a large homogeneous group of 14 403 patients transplanted for early leukaemia from an HLAidentical sibling and reported to the EBMT in four time cohorts : 1980-1989 (24%), 1990-1994 (26%), 1995-1998 (30%) and 1999-2001 (20%). We focused on death from infection. End points were survival, death from relapse and transplant-related mortality (TRM), which was subdivided into death from graft-versus-host disease (GvHD) (1315 patients; 25% of deaths), infection (597 patients; 11% of deaths) or 'other' causes (1875 patients; 34% of deaths). Survival increased from 52% at 5 years in the first to 62% in the third cohort (Po0.05) and TRM decreased from 36 to 26% (Po0.05) due to a reduction in death from infection (Po0.001). GvHD, 'other' causes and relapse did not improve. The relative proportions of bacteria (217 patients; 36%), viruses (183 patients; 31%), fungi (166 patients; 28%) or parasites (32 patients; 5%) as cause of infectious death (cumulative incidence of death at 5 years 1.8, 1.6, 1.4 and X0.3%, respectively) and median time to death from infections (3 months (range 0-158 months)) did not change. Death from infections has been reduced significantly, but it still represents an ongoing risk after HSCT and draws attention to the time beyond the initial period of neutropenia.

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Outbreaks of infectious diseases in stem cell transplant units: a silent cause of death for patients and transplant programmes

Cited by 61 publications

References 37 publications

Molecular epidemiological investigation of an outbreak of Pseudomonas aeruginosa infection in an SCT unit

Molecular epidemiological investigation of an outbreak of Pseudomonas aeruginosa infection in an SCT unit

Antibiotic cycling to decrease bacterial antibiotic resistance: a 5-year experience on a bone marrow transplant unit

Cause of death after allogeneic haematopoietic stem cell transplantation (HSCT) in early leukaemias: an EBMT analysis of lethal infectious complications and changes over calendar time

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