Impact of peri-transplant vancomycin and fluoroquinolone administration on rates of bacteremia in allogeneic hematopoietic stem cell transplant (HSCT) recipients: A 12-year single institution study Journal Article

   


Authors: Seo, S. K.; Xiao, K.; Huang, Y. T.; Jongwutiwes, U.; Chung, D.; Maloy, M.; Giralt, S.; Barker, J. N.; Jakubowski, A. A.; Papanicolaou, G. A.
Article Title: Impact of peri-transplant vancomycin and fluoroquinolone administration on rates of bacteremia in allogeneic hematopoietic stem cell transplant (HSCT) recipients: A 12-year single institution study
Abstract: Background: We analyzed the effect of peri-transplant prophylaxis on the epidemiology of bacteremia in a 12-year contemporary cohort of allogeneic HSCT recipients at our center. Methods: This was an observational study of 1052 consecutive adult HSCT from 2000 to 2011. Formal prophylaxis with vancomycin only, fluoroquinolone (FQ) only, or vancomycin+FQ was implemented in 2006. The cumulative incidence of day 100 bacteremia was compared between the Early Period (2000-2005) and the Recent Period (2006-2011). Predictors for pre-engraftment bacteremia were analyzed with Cox-proportional hazard models in a subcohort of 821 HSCT who received myeloablative or reduced intensity conditioning (MA/RIC). Results: The incidence of bacteremia decreased in the Recent Period (32% vs 27%; P=0.002), whereas the rates of resistance in gram-negative rods (GNR) and vancomycin-resistant enterococci (VRE) were similar between the two Periods (. P values are not statistically significant.) In multivariate analyses, prophylaxis with vancomycin only or vancomycin+FQ was protective (HR=0.5; CI=0.30-0.72) and (HR=0.3; CI=0.12-0.52, P<0.01). Vancomycin or vancomycin+FQ eliminated viridans streptococcal bacteremia (VSB); vancomycin+FQ decreased GNR bacteremia (HR=0.35; CI=0.15-0.85). Conclusions: Vancomycin-based prophylaxis peri-transplant in MA/RIC HSCT was associated with elimination of VSB and may be considered at centers with high incidence of this infection.
Keywords: adult; controlled study; aged; major clinical study; drug efficacy; outcome assessment; cohort analysis; risk assessment; myeloablative conditioning; ciprofloxacin; allogeneic hematopoietic stem cell transplantation; perioperative period; bacteremia; enterococcus; infection prevention; vancomycin; observational study; quinoline derived antiinfective agent; infection risk; allogeneic transplant; gram negative bacterium; alpha hemolytic streptococcus; viridans streptococci; bacterial clearance; human; male; female; article; vancomycin prophylaxis; fluoroquinolone prophylaxis
Journal Title: Journal of Infection
Volume: 69
Issue: 4
ISSN: 0163-4453
Publisher: W.B. Saunders Co.  
Date Published: 2014-10-01
Start Page: 341
End Page: 351
Language: English
DOI: 10.1016/j.jinf.2014.06.004
PROVIDER: scopus
PMCID: PMC4163089
PUBMED: 24931578
DOI/URL:

http://www.scopus.com/inward/record.url?eid=2-s2.0-84908506410&partnerID=40&md5=969bdace4f817b54a0ff9da24d89f559
Notes: Export Date: 1 December 2014 -- Source: Scopus
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MSK Authors
  1. Susan Seo
    120 Seo
  2. Sergio Andres Giralt
    1050 Giralt
  3. Genovefa A Papanicolaou
    238 Papanicolaou
  4. Ann Jakubowski
    455 Jakubowski
  5. Juliet N Barker
    335 Barker
  6. Ubonvan Jongwutiwes
    4 Jongwutiwes
  7. Molly Anna Maloy
    269 Maloy
  8. Dick Chung
    13 Chung
  9. Kun Xiao
    9 Xiao
  10. Yao-Ting Huang
    28 Huang
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