Epidemiology, Drug Resistance, and Risk Factors for Mortality Among Hematopoietic Stem Cell Transplantation Recipients with Hospital-Acquired Infections: A Single-Center Retrospective Study from China.

OBJECTIVE

Infection is the most common complication and cause of death after hematopoietic stem cell transplantation (HSCT). Our study aims to investigate the clinical characteristics and risk factors for death of infections in HSCT recipients, so as to provide evidence for guiding antibiotic use and improving prognosis in the future.

METHODS

The epidemiology, clinical manifestations and drug resistance rate with infections among HSCT recipients between January 1, 2012 and September 30, 2021 were retrospectively reviewed. Logistic regression model and Cox regression model were respectively used to determine the risk factors for carbapenem-resistant (CRKP) acquisition and death.

RESULTS

Fifty-nine HSCT recipients suffered from infections, with a mortality rate of 42.4%. The most common site was lung, followed by blood stream. The resistance rate of to various clinically common antibiotics was high, especially CRKP, which was only sensitive to amikacin and tigecycline. Independent risk factor for CPKP acquisition was a previous infection within 3 months before transplantation (OR=10.981, 95% CI 1.474-81.809, =0.019). Independent risk factors for mortality included interval from diagnosis to transplantation > 180 days (HR=3.963, 95% CI 1.25-12.561, =0.019), engraftment period > 20 days (HR=8.015, 95% CI 2.355-27.279, =0.001), non-use of anti-CMV immunoglobulin/rituximab after transplantation (HR=10.720, 95% CI 2.390-48.089, =0.002), and PCT > 5 μg/L (HR=5.906, 95% CI 1.623-21.500, =0.007).

CONCLUSION

infection has become a serious threat for HSCT recipients, which reminds us to pay enough attention and actively seek new strategies.