Revista do Instituto de Medicina Tropical de São Paulo (Dec 2018)

Bloodstream infection in hematopoietic stem cell transplantation outpatients: risk factors for hospitalization and death

  • Rachel Russo,
  • Elisa Teixeira Mendes,
  • Anna Sara Levin,
  • Frederico Dulley,
  • Maura S. Oliveira,
  • Maria Aparecida Shikanai-Yasuda,
  • Silvia Figueiredo Costa

DOI
https://doi.org/10.1590/s1678-9946201961003
Journal volume & issue
Vol. 61, no. 0

Abstract

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ABSTRACT We described 235 bloodstream infection (BSI) episodes in 146 hematopoietic stem cell transplantation (HSCT) outpatients and evaluated risk factors for hospitalization and death. Records of outpatients presenting with positive blood cultures over a 5-year period (January 2005 to December 2008) were reviewed. Variables with p< 0.1 in bivariate analysis were used in a regression logistic model. A total of 266 agents were identified, being 175 (66.7%) gram-negative, 80 (30.3%) gram-positive bacteria and 9 (3.4%) fungi. The most common underlying disease was acute leukemia 40 (27.4%), followed by lymphoma non-Hodgkin 26 (18%) and 87 patients (59.6%) were submitted to allogeneic hematopoietic stem cell transplant (HSCT). BSI episodes were more frequent during the first 100 days after transplantation (183 or 77.8%), and ninety-one (38.7%) episodes of BSI occurred up to the first 30 days. Hospitalization occurred in 26% of the episodes and death in 10% of cases. Only autologous HSCT was protector for hospitalization. Although, central venous catheter (CVC) withdrawal and the Multinational Association of Supportive Care in Cancer (MASCC) score up to 21 points were protector factors for death in the bivariate analysis, only MASCC remained as protector.

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