Bacteraemia in haematopoietic stem cell transplant recipients in a single tertiary referral centre
Bacteraemia is a common and one of the serious complications in haematopoietic stem cell transplantation (HSCT). To date, there are no published data on antibiotic resistance and clinical outcome among HSCT recipients in Malaysia. The aim of the present study was to analyse the prevalence, antibi...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Pusat Perubatan Universiti Kebangsaan Malaysia
2019
|
| Online Access: | http://journalarticle.ukm.my/15548/ http://journalarticle.ukm.my/15548/1/6_ms0294_pdf_87624.pdf |
| _version_ | 1848813823737200640 |
|---|---|
| author | Nurul Iman P, Ramliza Ramli, Wan Fariza Wan Jamaludin, Shamsul Azhar Shah, Nor Azimah I, S. Fadilah Abd. Wahid, |
| author_facet | Nurul Iman P, Ramliza Ramli, Wan Fariza Wan Jamaludin, Shamsul Azhar Shah, Nor Azimah I, S. Fadilah Abd. Wahid, |
| author_sort | Nurul Iman P, |
| building | UKM Institutional Repository |
| collection | Online Access |
| description | Bacteraemia is a common and one of the serious complications in haematopoietic
stem cell transplantation (HSCT). To date, there are no published data on antibiotic
resistance and clinical outcome among HSCT recipients in Malaysia. The aim
of the present study was to analyse the prevalence, antibiotic resistance and
clinical outcome of bacteraemia in HSCT recipients, within 100 days following
transplantation. We retrospectively analysed the prevalence, antibiotic resistance
pattern and mortality rate of early bacteraemia among HSCT recipients in a single
centre over a 5-year period (2013-2017). Thirty patients of 85 HSCT recipients
developed bacteraemia with 40 positive cultures resulting in prevalence of
47% (40/85). Gram negative bacteria (GNB) accounted for 60.5% of total
isolates. Enterobacteriaceae and Coagulase negative Staphylococcus (CoNS)
were the commonest pathogens isolated. GNB showed a high resistance rate to
ciprofloxacin. Only 30% of recipients responded to first line empirical antibiotics
for febrile neutropenia (FN). The mortality rate was 13.3% (4/30), of which 50%
was attributed to multi-drug resistance (MDR) Acinetobacter and 25% to extended
spectrum beta-lactamase (ESBL) Enterobacteriaceae. Bacteraemia is a frequent and
life-threatening early complication among HSCT recipients with MDR GNB being
the commonest cause of mortality. The high rate of resistance to ciprofloxacin
and failure of the first line empirical antibiotics to treat FN calls for a thorough
evaluation of the current antibiotic prophylaxis and empirical treatment protocols.
These findings have important clinical implications regarding the use and selection
of both prophylactic and empiric antibiotic regimens to treat FN. |
| first_indexed | 2025-11-15T00:24:19Z |
| format | Article |
| id | oai:generic.eprints.org:15548 |
| institution | Universiti Kebangasaan Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-15T00:24:19Z |
| publishDate | 2019 |
| publisher | Pusat Perubatan Universiti Kebangsaan Malaysia |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | oai:generic.eprints.org:155482020-11-04T15:39:33Z http://journalarticle.ukm.my/15548/ Bacteraemia in haematopoietic stem cell transplant recipients in a single tertiary referral centre Nurul Iman P, Ramliza Ramli, Wan Fariza Wan Jamaludin, Shamsul Azhar Shah, Nor Azimah I, S. Fadilah Abd. Wahid, Bacteraemia is a common and one of the serious complications in haematopoietic stem cell transplantation (HSCT). To date, there are no published data on antibiotic resistance and clinical outcome among HSCT recipients in Malaysia. The aim of the present study was to analyse the prevalence, antibiotic resistance and clinical outcome of bacteraemia in HSCT recipients, within 100 days following transplantation. We retrospectively analysed the prevalence, antibiotic resistance pattern and mortality rate of early bacteraemia among HSCT recipients in a single centre over a 5-year period (2013-2017). Thirty patients of 85 HSCT recipients developed bacteraemia with 40 positive cultures resulting in prevalence of 47% (40/85). Gram negative bacteria (GNB) accounted for 60.5% of total isolates. Enterobacteriaceae and Coagulase negative Staphylococcus (CoNS) were the commonest pathogens isolated. GNB showed a high resistance rate to ciprofloxacin. Only 30% of recipients responded to first line empirical antibiotics for febrile neutropenia (FN). The mortality rate was 13.3% (4/30), of which 50% was attributed to multi-drug resistance (MDR) Acinetobacter and 25% to extended spectrum beta-lactamase (ESBL) Enterobacteriaceae. Bacteraemia is a frequent and life-threatening early complication among HSCT recipients with MDR GNB being the commonest cause of mortality. The high rate of resistance to ciprofloxacin and failure of the first line empirical antibiotics to treat FN calls for a thorough evaluation of the current antibiotic prophylaxis and empirical treatment protocols. These findings have important clinical implications regarding the use and selection of both prophylactic and empiric antibiotic regimens to treat FN. Pusat Perubatan Universiti Kebangsaan Malaysia 2019 Article PeerReviewed application/pdf en http://journalarticle.ukm.my/15548/1/6_ms0294_pdf_87624.pdf Nurul Iman P, and Ramliza Ramli, and Wan Fariza Wan Jamaludin, and Shamsul Azhar Shah, and Nor Azimah I, and S. Fadilah Abd. Wahid, (2019) Bacteraemia in haematopoietic stem cell transplant recipients in a single tertiary referral centre. Medicine & Health, 14 (2). pp. 60-76. ISSN 2289-5728 https://www.medicineandhealthukm.com/toc/14/2 |
| spellingShingle | Nurul Iman P, Ramliza Ramli, Wan Fariza Wan Jamaludin, Shamsul Azhar Shah, Nor Azimah I, S. Fadilah Abd. Wahid, Bacteraemia in haematopoietic stem cell transplant recipients in a single tertiary referral centre |
| title | Bacteraemia in haematopoietic stem cell transplant recipients in a single tertiary referral centre |
| title_full | Bacteraemia in haematopoietic stem cell transplant recipients in a single tertiary referral centre |
| title_fullStr | Bacteraemia in haematopoietic stem cell transplant recipients in a single tertiary referral centre |
| title_full_unstemmed | Bacteraemia in haematopoietic stem cell transplant recipients in a single tertiary referral centre |
| title_short | Bacteraemia in haematopoietic stem cell transplant recipients in a single tertiary referral centre |
| title_sort | bacteraemia in haematopoietic stem cell transplant recipients in a single tertiary referral centre |
| url | http://journalarticle.ukm.my/15548/ http://journalarticle.ukm.my/15548/ http://journalarticle.ukm.my/15548/1/6_ms0294_pdf_87624.pdf |