Surveillance of nosocomial sepsis and pneumonia in patients with a bone marrow or peripheral blood stem cell transplant:: A multicenter project

被引:78
作者
Dettenkofer, M
Wenzler-Röttele, S
Babikir, R
Bertz, H
Ebner, W
Meyer, E
Rüden, H
Gastmeier, P
Daschner, FD
机构
[1] Univ Hosp, Inst Environm Med, D-79106 Freiburg, Germany
[2] Univ Hosp, Hosp Epidemiol, D-79106 Freiburg, Germany
[3] Univ Hosp, Dept Med 1, Univ Med Ctr, D-79106 Freiburg, Germany
[4] Charite, Inst Hyg & Environm Med, Berlin, Germany
[5] Hannover Med Sch, Dept Med Microbiol, D-3000 Hannover, Germany
[6] Hannover Med Sch, Hosp Epidemiol, D-3000 Hannover, Germany
[7] Natl Reference Ctr Surveillance Nosocomial Infect, Berlin, Germany
[8] Natl Reference Ctr Surveillance Nosocomial Infect, Hannover, Germany
[9] Natl Reference Ctr Surveillance Nosocomial Infect, Freiburg, Germany
关键词
D O I
10.1086/428046
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. For surveillance of nosocomial bloodstream infections (BSIs) and pneumonia during neutropenia in adult patients who have undergone bone marrow transplantation (BMT) or peripheral blood stem cell transplantation (PBSCT), a multicenter study - the Hospital Infection Surveillance System for Patients with Hematologic/Oncologic Malignancies (ONKO-KISS) - was initiated in Germany in 2000. Methods. Nosocomial infections were identified in neutropenic patients by means of Centers for Disease Control and Prevention definitions for laboratory-confirmed BSI and modified criteria for pneumonia. Results. During the first 38-month period of the study (i.e., through December 2003), a total of 1899 patients associated with 28,273 neutropenic days were investigated. Of these, 1173 (62%) had undergone allogeneic and 726 (38%) had undergone autologous BMT or PBSCT. The mean duration of neutropenia was 14.9 days (9.6 and 18.1 days after autologous and allogeneic transplantation, respectively). Overall, 395 BSIs and 168 cases of pneumonia were identified. The pooled mean site-specific incidence density per 1000 neutropenic days was 14.0 for BSI (12.4 and 18.9 for the allogeneic and autologous transplantation groups, respectively) and 5.9 for pneumonia (6.1 and 5.6 in the allogeneic and autologous transplantation groups, respectively). After allogeneic transplantation, 22.4 BSIs per 100 patients and 11.0 cases of pneumonia per 100 patients occurred, whereas 18.2 BSIs per 100 patients and 5.4 cases of pneumonia per 100 patients occurred after autologous transplantation. The majority (57%) of pathogens associated with BSI were coagulase-negative staphylococci. Conclusions. The ongoing ONKO-KISS project provides unprecedented reference data about the incidence of pneumonia and sepsis among BMT recipients and PBSCT recipients in Germany. These data will be used for further evaluation of the impact of hygiene measures and therapeutic regimens for these patients.
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页码:926 / 931
页数:6
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