Epidemiology, Microbiology, and Risk Factors of Bacterial Bloodstream Infections in Patients After Allogeneic Hematopoietic Stem Cell Transplantation

Figures & data

Table 1 Resistance Rate of Major Gram-Negative Bacteria to Common Antibacterial Drugs

Antibacterial Drugs	Escherichia coli		Klebsiella pneumoniae
	Number	Rate(%)	Number	Rate(%)
Ampicillin	20	95.2	7	100
Ampicillin/Sulbactam	14	77.8	6	85.7
Amikacin	–	–	1	14.3
Aztreonam	8	38.1	3	42.9
Ceftazidime	10	47.6	3	42.9
Cefoperazone/Sulbactam	7	33.3	4	57.1
Piperacillin/tazobactam	–	–	2	66.7
Ciprofloxacin	20	95.2	5	71.4
Ceftriaxone	13	61.9	3	42.9
Cefotetan	2	20	–	–
Cefuroxime	9	64.3	3	42.9
Cefuroxime axetil	7	63.6	4	80
Cefazolin	20	95.2	6	85.7
Ertapenem	3	14.3	1	14.3
Cefepime	10	47.6	2	28.6
Cefoxitin	6	28.6	2	28.6
Gentamicin	12	70.6	2	40
Imipenem	2	9.5	1	14.3
Levofloxacin	19	90.5	5	71.4
Meropenem	2	9.5	1	16.7
Compound trimethoprim	–	–	4	100
Minocycline	6	33.3	4	80

Table 2 Univariate Analysis of Risk Factors for BSI

Risk Factors	Total Number of Patients	Number of Patients with BSI (%)	Number of Patients Without BSI (%)	χ²	P
Gender
Male	177	28 (19.7)	114 (80.3)	0.658	0.417
Female	154	17 (15.7)	91 (84.3)
Age
≤40y	208	27 (16.8)	134 (83.2)	0.463	0.496
>40y	123	18 (20.2)	71 (79.8)
Primary Disease
AML	148	26 (24.8)	79 (75.2)	5.608	0.018
Others	183	19 (13.1)	126 (86.9)
Chemotherapy course
≤5	315	41 (17.3)	196 (82.7)	0.740	0.390
>5	16	4 (30.8)	9 (69.2)
ATG in regimen
Yes	268	41 (20.1)	163 (79.9)	3.306	0.069
No	63	4 (8.7)	42 (91.3)
History of previous BSI
Yes	83	21 (30.9)	47 (69.1)	10.502	0.001
No	248	24 (13.2)	158 (86.8)
Duration of neutropenia
>17d	202	33 (20.6)	127 (79.4)	2.075	0.150
≤17d	129	12 (13.3)	78 (86.7)
Type of donor
Haploidentical donor	222	34 (19.7)	139 (80.3)	1.200	0.549
Matched sibling donor	85	9 (15.3)	50 (84.7)
Alternative donor	24	2 (11.1)	16 (88.9)
Acute GVHD
Yes	55	11 (23.9)	35 (76.1)	1.335	0.248
No	276	34 (16.7)	170 (83.3)
Grade of Acute GVHD
<2	313	38 (16.4)	194 (83.6)	4.311	0.038
≥2	18	7 (38.9)	11 (61.1)

Abbreviations: AML, Acute myeloid leukemia; ATG, Anti-thymocyte globulin; BSI, Bloodstream infection; GVHD, graft-versus-host disease.

Table 3 Multivariate Analysis of Risk Factors for BSI

Risk Factors	P-value	OR	95% CI
AML	0.085	1.850	0.919–3.723
History of previous BSI	0.021	2.294	1.132–4.649
ATG in regimen	0.076	2.855	0.895–9.107
Acute GVHD grade≥2	0.017	3.828	1.265–11.579

Abbreviations: AML, Acute myeloid leukemia; ATG, Anti-thymocyte globulin; BSI, Bloodstream infection; GVHD, graft-versus-host disease.