Effectiveness of surveillance cultures for high priority multidrug-resistant bacteria in hematopoietic stem cell transplant units
ABSTRACT Surveillance strategies to detect colonization are an important tool to prevent and control the spread of microorganisms in hematopoietic stem cell transplant (HSCT) units. The aim of this study was to evaluate routine surveillance cultures for screening colonization and infection by carbap...
Published in: | Revista do Instituto de Medicina Tropical de São Paulo |
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Universidade de São Paulo (USP)
2021
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Online Access: | https://doi.org/10.1590/s1678-9946202163077 https://doaj.org/article/3dbc9348542b43a4a282d8bae5b1e823 |
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ftdoajarticles:oai:doaj.org/article:3dbc9348542b43a4a282d8bae5b1e823 2024-09-09T19:27:29+00:00 Effectiveness of surveillance cultures for high priority multidrug-resistant bacteria in hematopoietic stem cell transplant units Elisa Teixeira Mendes Matias Chiarastelli Salomão Lísia Moura Tomichi Maura Salaroli Oliveira Mariana Graça Flavia Rossi Fernanda Sapadao Thais Guimarães Vanderson Rocha Silvia Figueiredo Costa 2021-11-01T00:00:00Z https://doi.org/10.1590/s1678-9946202163077 https://doaj.org/article/3dbc9348542b43a4a282d8bae5b1e823 EN eng Universidade de São Paulo (USP) http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652021000100244&tlng=en https://doaj.org/toc/1678-9946 1678-9946 doi:10.1590/s1678-9946202163077 https://doaj.org/article/3dbc9348542b43a4a282d8bae5b1e823 Revista do Instituto de Medicina Tropical de São Paulo, Vol 63 (2021) Hematopoietic stem cell transplant infection Hospital-acquired infection Multidrug-resistant organisms Surveillance cultures Blood stream infection Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2021 ftdoajarticles https://doi.org/10.1590/s1678-9946202163077 2024-08-05T17:49:30Z ABSTRACT Surveillance strategies to detect colonization are an important tool to prevent and control the spread of microorganisms in hematopoietic stem cell transplant (HSCT) units. The aim of this study was to evaluate routine surveillance cultures for screening colonization and infection by carbapenem-resistant Enterobacteriaceae (CRE), carbapenem-resistant Pseudomonas aeruginosa (CRPa), and vancomycin-resistant enterococci (VRE). Surveillance cultures were collected (1,323 samples) from 200 patients admitted to an HSCT unit over one year; swabs were taken on admission and then weekly. We compared the positivity of cultures for each site, agent, clinical and epidemiological data according to the colonization status. Infection due to multidrug-resistant organisms (MDROs) occurred in 52 (21.5%) patients, 45 (86.5%) due to blood stream infection; 12 (23%) patients had a positive surveillance culture before the infection. Cultures of 554 (41.8%) samples were performed for CRPa, 413 (31.2%) for VRE and 356 (27%) for CRE. Of these, 179 (13.5%) were positive. Colonization by any MDRO, CRE or CRPa was associated with increased risk of infection (P < 0.05), but not with death. Previous colonization by an MDRO was a significant risk for infection by these pathogens, specially by CRE. Overall, rectal swabs had the highest positivity rate compared with other sites, oropharynx swabs were an option for CRPa, and fecal cultures showed low positivity. Although the impact of the strategy on the mortality of patients undergoing HSCT is not clear, routine VRE surveillance should be questioned with regard to patients undergoing auto-HSCT due to the additional cost and little impact on survival rates. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Revista do Instituto de Medicina Tropical de São Paulo 63 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Hematopoietic stem cell transplant infection Hospital-acquired infection Multidrug-resistant organisms Surveillance cultures Blood stream infection Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Hematopoietic stem cell transplant infection Hospital-acquired infection Multidrug-resistant organisms Surveillance cultures Blood stream infection Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Elisa Teixeira Mendes Matias Chiarastelli Salomão Lísia Moura Tomichi Maura Salaroli Oliveira Mariana Graça Flavia Rossi Fernanda Sapadao Thais Guimarães Vanderson Rocha Silvia Figueiredo Costa Effectiveness of surveillance cultures for high priority multidrug-resistant bacteria in hematopoietic stem cell transplant units |
topic_facet |
Hematopoietic stem cell transplant infection Hospital-acquired infection Multidrug-resistant organisms Surveillance cultures Blood stream infection Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
ABSTRACT Surveillance strategies to detect colonization are an important tool to prevent and control the spread of microorganisms in hematopoietic stem cell transplant (HSCT) units. The aim of this study was to evaluate routine surveillance cultures for screening colonization and infection by carbapenem-resistant Enterobacteriaceae (CRE), carbapenem-resistant Pseudomonas aeruginosa (CRPa), and vancomycin-resistant enterococci (VRE). Surveillance cultures were collected (1,323 samples) from 200 patients admitted to an HSCT unit over one year; swabs were taken on admission and then weekly. We compared the positivity of cultures for each site, agent, clinical and epidemiological data according to the colonization status. Infection due to multidrug-resistant organisms (MDROs) occurred in 52 (21.5%) patients, 45 (86.5%) due to blood stream infection; 12 (23%) patients had a positive surveillance culture before the infection. Cultures of 554 (41.8%) samples were performed for CRPa, 413 (31.2%) for VRE and 356 (27%) for CRE. Of these, 179 (13.5%) were positive. Colonization by any MDRO, CRE or CRPa was associated with increased risk of infection (P < 0.05), but not with death. Previous colonization by an MDRO was a significant risk for infection by these pathogens, specially by CRE. Overall, rectal swabs had the highest positivity rate compared with other sites, oropharynx swabs were an option for CRPa, and fecal cultures showed low positivity. Although the impact of the strategy on the mortality of patients undergoing HSCT is not clear, routine VRE surveillance should be questioned with regard to patients undergoing auto-HSCT due to the additional cost and little impact on survival rates. |
format |
Article in Journal/Newspaper |
author |
Elisa Teixeira Mendes Matias Chiarastelli Salomão Lísia Moura Tomichi Maura Salaroli Oliveira Mariana Graça Flavia Rossi Fernanda Sapadao Thais Guimarães Vanderson Rocha Silvia Figueiredo Costa |
author_facet |
Elisa Teixeira Mendes Matias Chiarastelli Salomão Lísia Moura Tomichi Maura Salaroli Oliveira Mariana Graça Flavia Rossi Fernanda Sapadao Thais Guimarães Vanderson Rocha Silvia Figueiredo Costa |
author_sort |
Elisa Teixeira Mendes |
title |
Effectiveness of surveillance cultures for high priority multidrug-resistant bacteria in hematopoietic stem cell transplant units |
title_short |
Effectiveness of surveillance cultures for high priority multidrug-resistant bacteria in hematopoietic stem cell transplant units |
title_full |
Effectiveness of surveillance cultures for high priority multidrug-resistant bacteria in hematopoietic stem cell transplant units |
title_fullStr |
Effectiveness of surveillance cultures for high priority multidrug-resistant bacteria in hematopoietic stem cell transplant units |
title_full_unstemmed |
Effectiveness of surveillance cultures for high priority multidrug-resistant bacteria in hematopoietic stem cell transplant units |
title_sort |
effectiveness of surveillance cultures for high priority multidrug-resistant bacteria in hematopoietic stem cell transplant units |
publisher |
Universidade de São Paulo (USP) |
publishDate |
2021 |
url |
https://doi.org/10.1590/s1678-9946202163077 https://doaj.org/article/3dbc9348542b43a4a282d8bae5b1e823 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista do Instituto de Medicina Tropical de São Paulo, Vol 63 (2021) |
op_relation |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652021000100244&tlng=en https://doaj.org/toc/1678-9946 1678-9946 doi:10.1590/s1678-9946202163077 https://doaj.org/article/3dbc9348542b43a4a282d8bae5b1e823 |
op_doi |
https://doi.org/10.1590/s1678-9946202163077 |
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Revista do Instituto de Medicina Tropical de São Paulo |
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63 |
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