期刊
BONE MARROW TRANSPLANTATION
卷 46, 期 9, 页码 1231-1239出版社
SPRINGERNATURE
DOI: 10.1038/bmt.2010.286
关键词
allogeneic hematopoietic SCT; bloodstream infections; levofloxacin; antibiotic prophylaxis
资金
- Taiwan Clinical Oncology Research Foundation
- Taipei Veterans General Hospital [V98A-029, V96-C1-090]
- [NSC95-2314-B-075-087]
This study aimed to determine the impact of blood stream infections (BSIs) on outcome of allogeneic hematopoietic SCT (HSCT), and to examine the influence of old (non-levofloxacin-containing) and new (levofloxacin-based) prophylactic antibiotic protocols on the pattern of BSIs. We retrospectively enrolled 246 allogeneic HSCT recipients between January 1999 and June 2006, dividing patients into BSI (within 6 months post-HSCT, n = 61) and non-BSI groups (n = 185). We found that Gram-negative bacteria (GNB) predominated BSI pathogens (54%). Multivariate analyses showed that patients with a BSI, compared with those without, had a significantly greater 6-month mortality (hazard ratio, 1.75; 95% confidence interval, 1.09-2.82; P -0.021) and a significantly increased length of hospital (LOH) stay (70.8 vs 55.2 days, P = 0.014). Moreover, recipients of old and new protocols did not have a significantly different 6-month mortality and time-to-occurrence of BSIs. However, there were significantly more resistant GNB to third-generation cephalosporins and carbapenem in recipients of levofloxacin-based prophylaxis. Our data suggest that BSIs occur substantially and impact negatively on the outcome and LOH stay after allogeneic HSCT despite antibiotic prophylaxis. Levofloxacin-based prophylaxis, albeit providing similar efficacy to non-levofloxacin-containing regimens, may be associated with increased antimicrobial resistance. Bone Marrow Transplantation (2011) 46, 1231-1239; doi:10.1038/bmt.2010.286; published online 29 November 2010
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