Screening and clinical significance of intestinal colonization of carbapenem-resistant Enterobacteriaceae (CRE) in patients before haploidentical hematopoietic stem cell transplantation
Journal Title: Chinese Journal of Blood Transfusion - Year 2023, Vol 36, Issue 6
Abstract
Objective To investigate the situation of carbapenem-resistant Enterobacteriaceae(CRE) colonization in patients undergoing haploidentical hematopoietic stem cell transplantation (haplo-HSCT). Methods A total of 241 consecutive patients who underwent haplo-HSCT in the First Affiliated Hospital of Soochow University from June 1, 2021 to June 1, 2022 were enrolled. Anal swab screening was performed within 48 hours of admission and blood cultures were taken when the patient developed fever. Univariate and multivariate analysis were used to analyze the colonization rate, distribution, risk factors and the correlation between CRE colonization and post-transplant bloodstream infection(BSI). Results Among 241 patients with haplo-HSCT, there were 90 cases in CRE colonization positive group, with a colonization rate of 37.3% (90/241). Multivariate logistic regression analysis showed that sex (OR 2.42, 95% CI 1.38-4.22, P<0.05) and history of infection within 30 days before transplantation (OR 3.37, 95% CI 1.59-7.17, P<0.05) may be independent risk factors for CRE intestinal colonization. Of the 95 CRE strains, the top five species were carbapenem-resistant Klebsiella pneumoniae (38/95, 40.0%), carbapenem-resistant Escherichia coli (29/95, 30.5%), carbapenem-resistant Enterobacter cloacae (13/95, 13.6%), carbapenem-resistant Klebsiella acidophilus (6/95, 6.3%) and carbapenem-resistant Proteus mirabilis (3/95, 3.1%). The incidence of post-transplant BSI was 12.0% (29/241) in the CRE-colonized group and 3.3% (8/241) in the non-colonized group. In the colonization group, 100% of the pathogens of BSI were identical with those of CRE colonization. Conclusion Bacterial culture of anal swab during haplo-HSCT is helpful for detection of CRE colonization in intestinal tract, which provides some clinical basis for active monitoring of key flora, prevention and control of infection.
Authors and Affiliations
Wenqi WU, Yuqi ZHANG, Jie XU, Zaixiang TANG, Shijia LI, Xiya WEI, Ling LI, Heqing WU, Xiao MA, Jisheng LIU, Depei WU, Xiaojin WU
Keywords
Related Articles
- EP ID EP738566
- DOI 10.13303/j.cjbt.issn.1004-549x.2023.06.009
- Views 46
- Downloads 0
Clinical transfusion consultation investigation and typical case analysis
Objective To analyze the characteristics of blood transfusion consultation cases and establish the consultation route, so as to provide reference for blood transfusion doctors to participate in blood transfusion consulta...
Molecular mechanism of ABO bood group variation
Objective To study the relationship between ABO subtype, para-Bombay blood group and genotype, so as to explore the possible molecular mechanism of these two blood groups, and provide accurate genetic detection targets a...
Correlation between malignant tumors and ABO blood types in Chaoshan area, Guangdong
Objective To investigate the relationship between ABO blood types and the risk of malignant tumors in Chaoshan area, Guangdong. Methods Chi-square test was used to analyze the distribution of ABO blood types between 45 8...
Relationship between lactate and alkali deficiency and blood transfusion therapy in patients with traumatic hemorrhagic shock
Objective To explore the effect of lactate and alkali deficiency on the need for red blood cell transfusion in emergency of patients with traumatic hemorrhagic shock. Methods A total of 126 patients with traumatic hemorr...
Animalexperiment on regulating effect of stored red blood cells transfusion on BMDMs in inflammatory conditions
Objective To discuss the regulating effect of stored red blood cells (RBCs) transfusion on BMDMs in inflammatory conditions, and the relationship between stored RBCs transfusion and inflammatory response induced by bacte...