دورية أكاديمية
Compositional Flux Within the Intestinal Microbiota and Risk for Bloodstream Infection With Gram-negative Bacteria.
| العنوان: | Compositional Flux Within the Intestinal Microbiota and Risk for Bloodstream Infection With Gram-negative Bacteria. |
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| المؤلفون: | Stoma I; Center for Microbes, Inflammation and Cancer, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, New York, USA.; Department of Infectious Diseases, Belarusian State Medical University, Minsk, Belarus., Littmann ER; Center for Microbes, Inflammation and Cancer, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, New York, USA., Peled JU; Adult Bone Marrow Transplantation Service, Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York, New York, USA.; Weill Cornell Medical College, New York, New York, USA., Giralt S; Adult Bone Marrow Transplantation Service, Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York, New York, USA.; Weill Cornell Medical College, New York, New York, USA., van den Brink MRM; Adult Bone Marrow Transplantation Service, Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York, New York, USA.; Weill Cornell Medical College, New York, New York, USA., Pamer EG; Center for Microbes, Inflammation and Cancer, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, New York, USA.; Weill Cornell Medical College, New York, New York, USA.; Infectious Diseases Service, Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York, New York, USA., Taur Y; Center for Microbes, Inflammation and Cancer, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, New York, USA.; Weill Cornell Medical College, New York, New York, USA.; Infectious Diseases Service, Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York, New York, USA. |
| المصدر: | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2021 Dec 06; Vol. 73 (11), pp. e4627-e4635. |
| نوع المنشور: | Journal Article; Research Support, N.I.H., Extramural |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: United States NLM ID: 9203213 Publication Model: Print Cited Medium: Internet ISSN: 1537-6591 (Electronic) Linking ISSN: 10584838 NLM ISO Abbreviation: Clin Infect Dis Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Jan. 2011- : Oxford : Oxford University Press Original Publication: Chicago, IL : The University of Chicago Press, c1992- |
| مواضيع طبية MeSH: | Bacteremia*/microbiology , Gastrointestinal Microbiome* , Hematopoietic Stem Cell Transplantation*/adverse effects , Sepsis*/complications, Gram-Negative Bacteria ; Humans ; Retrospective Studies |
| مستخلص: | Background: Gram-negative bloodstream infections (BSIs) represent a significant complication facing allogeneic hematopoietic cell transplant (allo-HCT) recipients, as a result of intestinal translocation during neutropenia. In this study we sought to better understand how the composition of the intestinal microbiota is connected to risk of gram-negative BSIs, expanding on our prior work in these patients. Methods: Fecal specimens were collected from recipients of allo-HCT and analyzed using 16S ribosomal RNA gene sequencing. Samples and clinical data extending from the pretransplant conditioning period through stem cell engraftment were used in the analysis. Intestinal domination (relative abundance ≥ 30%) by gram-negative bacteria was used as predictor of gram-negative BSI using Cox proportional hazards modeling. Further analysis of microbiota composition was performed at the genus level. Results: Seven hundred eight allo-HCT subjects were studied (7.5% developed gram-negative infection), with 4768 fecal samples for analysis. Gram-negative intestinal domination was associated with subsequent BSI, which was observed overall and individually at the genus level: Escherichia, Klebsiella, Enterobacter, Pseudomonas, and Stenotrophomonas. Fluoroquinolone prophylaxis was associated with decreased BSI and intestinal colonization by gram-negative microbes. In fluoroquinolone-prophylaxed patients, Escherichia coli was more frequently observed as breakthrough, both in terms of intestinal colonization and BSIs, compared with nonprophylaxed patients. Initial colonization by members of Ruminococcaceae and Bacteroidetes were associated with protection against gram-negative BSI. Conclusions: Gram-negative intestinal colonization is highly predictive of BSI in the setting of allo-HCT. Fluoroquinolones appear to reduce these infections by influencing gut colonization. (© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.) |
| التعليقات: | Comment in: Clin Infect Dis. 2021 Apr 8;72(7):1296-1297. (PMID: 32572461) |
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| معلومات مُعتمدة: | U01 Al124275 United States NH NIH HHS; R01 CA228308 United States CA NCI NIH HHS; P30 CA008748 United States CA NCI NIH HHS; K08 HL143189 United States HL NHLBI NIH HHS; National Institute of Allergy and Infectious Diseases; P01 CA023766 United States CA NCI NIH HHS; R01 AI137269 United States AI NIAID NIH HHS; P30 CA008748 United States NH NIH HHS |
| فهرسة مساهمة: | Keywords: allogeneic hematopoietic cell transplantation; gram-negative bloodstream infections; intestinal microbiota |
| تواريخ الأحداث: | Date Created: 20200125 Date Completed: 20220314 Latest Revision: 20220314 |
| رمز التحديث: | 20221213 |
| مُعرف محوري في PubMed: | PMC8662789 |
| DOI: | 10.1093/cid/ciaa068 |
| PMID: | 31976518 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1537-6591 |
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| DOI: | 10.1093/cid/ciaa068 |