Different screening frequencies of carbapenem-resistant Enterobacteriaceae in patients undergoing hematopoietic stem cell transplantation: which one is better?

Yang, Ting-Ting; Luo, Xue-Ping; Yang, Qing; Chen, Hong-Chao; Luo, Yi; Zhao, Yan-Min; Ye, Yi-Shan; Lai, Xiao-Yu; Yu, Jian; Tan, Ya-Min; Wei, Guo-Qing; Huang, He; Shi, Ji-Min

doi:10.1186/s13756-020-0706-0

Antimicrobial Resistance & Infection Control

Table 3 Clinical manifestations of the 24 patients colonized with CRE

From: Different screening frequencies of carbapenem-resistant Enterobacteriaceae in patients undergoing hematopoietic stem cell transplantation: which one is better?

Pt	Age /Sex	Disease/HSCT	CRE Isolate	Which times screening turned positive	Febrile episodes in carriers	Time from colonization to fever (day)	Time from fever to the use of tigecycline (hour)	ANC at fever (×10⁹/L)	Symptoms at fever	CRP (mg/L) /PCT (ug/L)	30 days status
Single screening
1^a	36/F	ALL/Haplo	E.coli	/	Yes	−3	> 72	0	Abdominal pain, diarrhoea	216.8/1.0	Dead
2	56/F	MM/Auto	E. coli	1	Yes	7	< 24	0	Chills, tremble	95.1/4.1	Alive
3	32/m	ALL/MUD	K.pneumoniae	1	Yes	5	< 24	0	No	48.9/normal	Alive
Continuous screening
4	36/M	AML/Haplo	K.pneumoniae	5	No	/	/	/	/	/	Alive
5	15/M	AML/Haplo	E. coli	2	Yes	9	< 24	0	Chills, tremble	73.0/normal	Alive
6	27/M	ALL/Haplo	E. coli	3	Yes	8	< 24	0	No	52.2/normal	Alive
7	48/M	AML/Haplo	E.coli	2	Yes	4	< 24	0	Perianal inflammation	112.3/ normal	Alive
8	45/M	AML/Haplo	K.pneumoniae	4	No	/	/	/	/	/	Alive
9	40/M	AL/Haplo	K.pneumoniae	1	No	/	/	/	/	/	Alive
10	38/M	T-LBL/Haplo	E. coli	3	Yes	11	< 24	0.5	No	43.2/normal	Alive
11	16/F	ALL/Haplo	E. coli	1	Yes	17	< 24	0	No	54.2/normal	Alive
12	18/M	ALL/MUD	E.coli	2	Yes	9	< 24	0	Chills, tremble	64.5/normal	Alive
13	25/M	ALL/Haplo	E.coli	2	Yes	8	< 24	0	No	61.2/normal	Alive
14	34/F	AML/Haplo	K.pneumoniae	3	No	/	/	/	/	/	Alive
15	44/M	MM/Auto	E.coli	4	No	/	/	/	/	/	Alive
16	50/M	AML/Sib	K.pneumoniae	1	Yes	15	< 24	0	sore throat	70.4/normal	Alive
17	18/M	ALL/Haplo	K.pneumoniae	5	No	/	/	/	/	/	Alive
18	51/M	ALL/Haplo	E.coli	5	No	/	/	/	/	/	Alive
19	22/M	ALL/Haplo	K.pneumoniae	4	No	/	/	/	/	/	Alive
20	22/F	AML/Haplo	K.pneumoniae	3	Yes	1	> 48	0	Chills, tremble	65.2/0.6	Alive
21	26/M	ALL/MUD	K.pneumoniae	1	Yes	13	< 24	0	No	73.4/normal	Alive
22	27/M	ALL/Haplo	K.pneumoniae	6	No	/	/	/	/	/	Alive
23	21/M	AML/Haplo	K.pneumoniae	2	Yes	12	< 24	0	Perianal inflammation	307/ normal	Alive
24	62/M	AML/Haplo	K.pneumoniae	6	Yes	2	< 24	0	No	141.7/normal	Alive

Abbreviations: AML Acute myeloid leukemia, ALL Acute lymphatic leukemia, AL Acute leukemia, Auto Autologous HSCT, CRP C-reactive protein (normal value: 0-8 mg/L)E.coli Escherichia coli, Haplo HLA-Haploidentical allogeneic HSCT, K.pneumoniae Klebsiella pneumoniae, MM Multiple myeloma, MUD Matched-unrelated donor allogeneic HSCT, PCT Procalcitonin (normal value:< 0.5μg/L), Sib HLA-sibling allogeneic HSCT, T-LBL T-lymphoblastic lymphoma
^aThe patient 1:single screening was negative for the patient, but subsequent screening indicated positive 3 days after the onset of fever and the patient died of septic shock
1.Four patients (2,12,20,23) were combined with polymyxin because of persistent fever after 48 h of tigecycline treatment, one of them (patient 20) developed CRE BSIs later

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ISSN: 2047-2994

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