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Ghosh S, Bhattacharya S, Goel G, Deshmukh RA, Javed R, Roychowdhury M, Sinha S, De MS, Nag A, Kumar J, Bhave SJ, Nair R, Chandy M. Hematopoietic stem-cell transplantation in a zoo of multidrug-resistant organisms: Data from a cancer center in eastern India. Transpl Infect Dis 2023; 25 Suppl 1:e14072. [PMID: 37260056 DOI: 10.1111/tid.14072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 04/19/2023] [Accepted: 05/15/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Infections by multidrug-resistant organisms (MDRO) are a major hurdle in hematopoietic stem-cell transplants (HSCTs). Conditioning regimens lead to mucosal barrier injury, which in-turn leads to transmigration of gut bacteria and sepsis. Pre-transplant stool and throat surveillance cultures can guide empirical antibiotic policy during the neutropenic period. In this paper, we document colonization with MDRO in pre-transplant surveillance cultures and the correlation with bloodstream infections in HSCT patients and analyze transplant outcomes with respect to these infections. METHODS A single-center, retrospective study on HSCT was performed between January 2021 and December 2021. The incidence of bacterial infections, percentage of MDROs, correlation with pre-transplant stool/throat surveillance cultures, and their impact on overall 100-day and post-100-day to 6-month post-transplant survival were analyzed. RESULTS Sixty-four patients were included in the study. Pre-transplant stool surveillance cultures were positive for MDRO in 85.9% of patients. Almost half (48.5%) of the isolates were positive for carbapenemase-producing genes (mainly New Delhi metallo-beta-lactamase-1 [NDM-1] and oxacillinase-48 [OXA-48]). Eighteen patients (18/64, 28%) had a positive blood culture for MDRO in the peri-engraftment neutropenic period. Correlation between surveillance and blood cultures was seen in 61% (11/18) of patients. All-cause mortality was 14.1% (9/64) and 25% (16/64) in patients at 100 days and 6 months post-HSCT, respectively. The 100-day and post-100-day all-cause mortality rates were higher in patients with Gram-negative MDRO bloodstream infections (p < .012 and <.008, respectively). CONCLUSION MDRO infections can adversely affect HSCT outcomes. Pre-transplant stool and throat surveillance cultures may guide empirical antibiotic policy and lead to favorable transplant outcomes.
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Affiliation(s)
- Shouriyo Ghosh
- Department of Clinical Haematology and BMT, Tata Medical Center, Kolkata, West Bengal, India
| | - Sanjay Bhattacharya
- Department of Microbiology, Tata Medical Center, Kolkata, West Bengal, India
| | - Gaurav Goel
- Department of Microbiology, Tata Medical Center, Kolkata, West Bengal, India
| | | | - Rizwan Javed
- Department of Clinical Haematology and BMT, Tata Medical Center, Kolkata, West Bengal, India
| | - Mita Roychowdhury
- Department of Clinical Haematology and BMT, Tata Medical Center, Kolkata, West Bengal, India
| | - Subir Sinha
- Department of Biostatistics, Tata Medical Center, Kolkata, West Bengal, India
| | - Maitrayee Sarkar De
- Hospital Infection Control Committee, Tata Medical Center, Kolkata, West Bengal, India
| | - Arijit Nag
- Department of Clinical Haematology and BMT, Tata Medical Center, Kolkata, West Bengal, India
| | - Jeevan Kumar
- Department of Clinical Haematology and BMT, Tata Medical Center, Kolkata, West Bengal, India
| | - Saurabh Jayant Bhave
- Department of Clinical Haematology and BMT, Tata Medical Center, Kolkata, West Bengal, India
| | - Reena Nair
- Department of Clinical Haematology and BMT, Tata Medical Center, Kolkata, West Bengal, India
| | - Mammen Chandy
- Department of Clinical Haematology and BMT, Tata Medical Center, Kolkata, West Bengal, India
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Sarkar A, Parihar M, Zameer L, Bhave SJ, Nair R, Dey D. 'Primary CNS Blastoid Variant of Mantle Cell Lymphoma: A Unique Case'. Indian J Hematol Blood Transfus 2022; 38:757-759. [PMID: 36258737 PMCID: PMC9569267 DOI: 10.1007/s12288-022-01537-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 04/04/2022] [Indexed: 10/18/2022] Open
Affiliation(s)
- Arindam Sarkar
- Department of Oncopathology, Tata Medical Center, Phase II, 14, MAR(E-W), DH Block(Newtown), Action Area I, Newtown, Kolkata, West Bengal 700160 India
| | - Mayur Parihar
- Department of Cytogenetics, Tata Medical Center, Phase II, 14, MAR(E-W), DH Block(Newtown), Action Area I, Newtown, Kolkata, West Bengal 700160 India
| | - Lateef Zameer
- Department of Oncopathology, Tata Medical Center, Phase II, 14, MAR(E-W), DH Block(Newtown), Action Area I, Newtown, Kolkata, West Bengal 700160 India
| | - Saurabh Jayant Bhave
- Department of Clinical Haematology, Tata Medical Center, Phase II, 14, MAR(E-W), DH Block(Newtown), Action Area I, Newtown, Kolkata, West Bengal 700160 India
| | - Reena Nair
- Department of Clinical Haematology, Tata Medical Center, Phase II, 14, MAR(E-W), DH Block(Newtown), Action Area I, Newtown, Kolkata, West Bengal 700160 India
| | - Debdeep Dey
- Department of Oncopathology, Tata Medical Center, Phase II, 14, MAR(E-W), DH Block(Newtown), Action Area I, Newtown, Kolkata, West Bengal 700160 India
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Pincha R, Radhakrishnan VS, Kumar J, Nag A, Bhave SJ, Zameer L, Vinarkar SS, Das J, Mishra DK, Chandy M, Nair R. Refractory Primary Mediastinal B-Cell Lymphoma: A Case Report of Conventional Chemotherapies, Immune Checkpoint Inhibitors, Polatuzumab Vedotin, Transplantation, and Post-Transplant Large Granular Lymphocytosis. Indian J Med Paediatr Oncol 2022. [DOI: 10.1055/s-0042-1749412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
AbstractWe report a case of stage IV primary mediastinal B-cell lymphoma in a 27-year-old young woman, who was refractory and chemoresistant to frontline conventional rituximab-based intensive chemotherapy and subsequent lines of conventional and immune checkpoint inhibitor-based therapies. She was successfully treated using a polatuzumab-based regimen and consolidated with an allogeneic haploidentical hematopoietic stem cell transplantation. She developed post-transplant large granular lymphocytosis that was managed conservatively. She is now relapse-free, 600 days post-transplant. The management of this patient provided several teaching points in the use of different modalities of immunotherapies in a hard-to-treat cancer and its related conditions.
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Affiliation(s)
- Rajat Pincha
- Clinical Hematology Oncology and HCT, Tata Medical Center, Kolkata, West Bengal, India
| | - Vivek S Radhakrishnan
- Clinical Hematology Oncology and HCT, Tata Medical Center, Kolkata, West Bengal, India
| | - Jeevan Kumar
- Clinical Hematology Oncology and HCT, Tata Medical Center, Kolkata, West Bengal, India
| | - Arijit Nag
- Clinical Hematology Oncology and HCT, Tata Medical Center, Kolkata, West Bengal, India
| | - Saurabh Jayant Bhave
- Clinical Hematology Oncology and HCT, Tata Medical Center, Kolkata, West Bengal, India
| | - Lateef Zameer
- Department of Histopathology, Tata Medical Center, Kolkata, West Bengal, India
| | - Sushant S. Vinarkar
- Laboratory Hematology and Molecular Pathology, Tata Medical Center, Kolkata, West Bengal, India
| | - Jayanta Das
- Department of Nuclear Medicine, Tata Medical Center, Kolkata, West Bengal, India
| | - Deepak Kumar Mishra
- Laboratory Hematology and Molecular Pathology, Tata Medical Center, Kolkata, West Bengal, India
| | - Mammen Chandy
- Clinical Hematology Oncology and HCT, Tata Medical Center, Kolkata, West Bengal, India
| | - Reena Nair
- Clinical Hematology Oncology and HCT, Tata Medical Center, Kolkata, West Bengal, India
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Javed R, Flores L, Bhave SJ, Jawed A, Mishra DK. The Future of Red Cell Transfusion Lies in Cultured Red Cells. Indian J Med Paediatr Oncol 2021. [DOI: 10.1055/s-0041-1740068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
AbstractBlood is a very important resource for healthcare-based services and there has been a consistently increasing demand for it in most parts of the world. Poor volunteer-based collection system, high-risk of transfusion-transmitted infections, and emergence of new pathogens as evident from the ongoing Coronavirus Disease 2019 (COVID-19) pandemic are potential challenges to the global healthcare systems. It is imperative to explore safe and reliable alternatives to red cell transfusions. Ex vivo culture of red cells (cRBCs) from different sources such as hematopoietic stem cells (HSCs), pluripotent stem cells, and immortalized progenitors (e.g., BELA-2 cells) could revolutionize transfusion medicine. cRBC could be of great diagnostic and therapeutic utility. It may provide a backup in times of acute shortages in patients with rare blood groups, and in cases with multiple antibodies or sickle cell anemia. The CRISP-Cas9 system has been used to develop personalized, multi-compatible RBCs for diagnostic reagents and patients with multiple allo-antibodies. cRBC could be practically feasible for pediatric patients, who require small quantities of red cell transfusions. cRBC produced under good manufacturing practice (GMP) conditions has been reported to survive in human blood circulation for more than 26 days. Recently, a phase I randomized controlled clinical trial called RESTORE was initiated to assess the survival and recovery of cRBCs. However, feasible technological advancement is required to produce enough cRBCs for clinical use. It is crucial to identify sustainable sources for large-scale production of clinically useful cRBCs. Although the potential cost of one unit of cRBC is extrapolated to be around US$ 8000, it is a life-saving product for patients having rare blood groups and is a “ready to use” source of phenotype-matched, homogenous young red cells in emergency situations.
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Affiliation(s)
- Rizwan Javed
- Department of Clinical Haematology and BMT, TATA Medical Center, Kolkata, West Bengal, India
| | - Lorraine Flores
- Department of Histocompatibility and Immunogenetics, NHS Blood and Transplant, Filton, Bristol, United Kingdom
| | - Saurabh Jayant Bhave
- Department of Clinical Haematology and BMT, TATA Medical Center, Kolkata, West Bengal, India
| | - Asheer Jawed
- Department of Respiratory Medicine at William Harvey Hospital, Ashford, United Kingdom
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Das A, Bhave SJ, Pal B, Arun I, Goel G, Bhattacharya S, Sen S, Das J, Bhattacharyya P. Brucellosis Complicated by Kikuchi-Fujimoto Disease and Doxycycline-Induced Intracranial Hypertension. Indian J Pediatr 2019; 86:1063-1064. [PMID: 30945234 DOI: 10.1007/s12098-019-02937-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 03/18/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Anirban Das
- Department of Pediatric Hematology-Oncology, Tata Medical Centre, 14 Major Arterial Road (EW), Rajarhat, Kolkata, 700160, India.
| | | | - Bikramjit Pal
- Department of Ophthalmology, Tata Medical Centre, Kolkata, India
| | - Indu Arun
- Department Histopathology, Tata Medical Centre, Kolkata, India
| | - Gaurav Goel
- Department of Microbiology, Tata Medical Centre, Kolkata, India
| | | | - Saugata Sen
- Department of Radiology, Tata Medical Centre, Kolkata, India
| | - Jayanta Das
- Department of Nuclear Medicine, Tata Medical Centre, Kolkata, India
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Singh MK, Sasikumaran Nair Remani A, Bhave SJ, Mishra DK, Arora N, Parihar M. Detection of BCR/ PDGRFα Fusion Using Dual Colour Dual Fusion BCR/ ABL1 Probe: An Illustrative Report. Indian J Hematol Blood Transfus 2019; 35:570-574. [PMID: 31388278 DOI: 10.1007/s12288-019-01095-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 02/05/2019] [Indexed: 11/26/2022] Open
Affiliation(s)
| | | | | | - Deppak Kumar Mishra
- 3Department of Lab Haematology and Molecular Genetics, Tata Medical Center, Kolkata, India
| | - Neeraj Arora
- 3Department of Lab Haematology and Molecular Genetics, Tata Medical Center, Kolkata, India
| | - Mayur Parihar
- 4Department of Cytogenetics and Lab Haematology, Tata Medical Center, Kolkata, India
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Kumar M, Roychowdhury M, Kumar J, Harishankar A, Sinha S, Bhave SJ, Chakrapani A, Radhakrishnan V, Nair R, Bhattacharya S, Chandy M. Cytomegalovirus reactivation and disease amongst patients with allogeneic haematopoietic stem cell transplantation in Eastern India: Epidemiology, outcome and healthcare cost. Indian J Med Microbiol 2018; 36:49-53. [PMID: 29735826 DOI: 10.4103/ijmm.ijmm_17_269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Purpose Data from developing countries about incidence, prognosis and healthcare cost of cytomegalovirus (CMV) reactivation amongst patients with allogeneic hematopoietic stem cell transplantation (AHSCT) remain scarce. The purpose of the study was to describe the epidemiology, outcome and cost implications of CMV reactivation and CMV disease amongst patients with AHSCT in cancer hospital in Eastern India. Materials and Methods The study design was a retrospective audit of clinical records. Results Ninety-nine per cent of patients and 94% of the donors were found to be CMV seropositive. CMV reactivation rate was 43.8% amongst patients with AHSCT (n = 130 patients). CMV reactivation occurred 118 days after AHSCT (median; range: 28-943 days). Patients with any grade of graft-versus-host disease (GVHD) had higher CMV reactivation rate than patients without GVHD. Patients with CMV reactivation had more frequent GVHD than patients without CMV reactivation. Use of steroids was associated with CMV reactivation. We found no differences in overall survival of patients with or without CMV reactivation. The cost of in-house CMV-polymerase chain reaction at our centre was USD $57 (Rs. 3650), cost for intravenous ganciclovir was USD $26 (Rs. 1665) per infusion and oral valganciclovir USD $8 (Rs. 512)/900 mg tablet. The median duration of anti-CMV therapy was 14 days (interquartile range: 14-28 days) and the average cost per patient per month directed towards CMV management ranged between USD $800 and USD $1,300 (Rs. 51,238-Rs. 83,264). Three patients (2.3%) in this series had CMV disease, all of whom died. Conclusion In an increasingly globalised world, where medical tourism is common, data from developing countries regarding cost and outcome of CMV infections in AHSCT patients are of relevance.
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Affiliation(s)
- Meet Kumar
- Department of Clinical Hematology, Tata Medical Center, Kolkata, West Bengal, India
| | - Mita Roychowdhury
- Department of Clinical Hematology, Tata Medical Center, Kolkata, West Bengal, India
| | - Jeevan Kumar
- Department of Clinical Hematology, Tata Medical Center, Kolkata, West Bengal, India
| | - Anusha Harishankar
- Department of Microbiology, Tata Medical Center, Kolkata, West Bengal, India
| | - Subir Sinha
- Department of Statistics, Tata Medical Center, Kolkata, West Bengal, India
| | - Saurabh Jayant Bhave
- Department of Clinical Hematology, Tata Medical Center, Kolkata, West Bengal, India
| | - Anupam Chakrapani
- Department of Clinical Hematology, Tata Medical Center, Kolkata, West Bengal, India
| | - Vivek Radhakrishnan
- Department of Clinical Hematology, Tata Medical Center, Kolkata, West Bengal, India
| | - Reena Nair
- Department of Clinical Hematology, Tata Medical Center, Kolkata, West Bengal, India
| | - Sanjay Bhattacharya
- Department of Microbiology, Tata Medical Center, Kolkata, West Bengal, India
| | - Mammen Chandy
- Department of Clinical Hematology, Tata Medical Center, Kolkata, West Bengal, India
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Shah SP, Radhakrishnan VS, Jaishetwar GS, Sukumaran RK, Roychowdhury M, Kumar J, Bhave SJ, Nair R, Chandy M. Myeloablative Conditioning Followed by T-Cell Replete Haploidentical Related Donor Peripheral Blood Stem Cell Transplant Using Post-Transplant Cyclophosphamide Immune Tolerance Approach for High Risk Haematological Malignancies: An Indian Perspective. Biol Blood Marrow Transplant 2018. [DOI: 10.1016/j.bbmt.2017.12.422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Arun I, Roy P, Arora N, Bhave SJ, Nair R, Chandy M. PAX-5 Positivity in Anaplastic Lymphoma Kinase-Negative Anaplastic Large Cell Lymphoma: A Case Report and Review of Literature. Int J Surg Pathol 2016; 25:333-338. [PMID: 28013563 DOI: 10.1177/1066896916683447] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Anaplastic lymphoma kinase (ALK)-negative anaplastic large cell lymphoma (ALCL) is a subtype of T-cell lymphomas that may mimic several other malignancies morphologically. With the help of immunohistochemistry, most cases of ALCL can be diagnosed on the basis of expression of T-cell lineage associated antigens. However, aberrations in the expression of immunohistochemical markers pose diagnostic challenges. The morphological and immunophenotypic features of ALCL show considerable overlap with classical Hodgkin lymphoma (CHL), which is a B-cell lymphoma. The 2008 World Health Organization Classification of Tumours of Haematopoietic and Lymphoid Tissues suggests that staining for the B-cell transcription factor, paired box 5 (PAX-5), is helpful in differentiating between them, as it is weakly positive in most CHL and should be negative in ALCL. We report a rare case of ALK-negative ALCL, which was positive for PAX-5 and CD15, mimicking CHL by immunohistochemistry, resulting in a diagnostic dilemma.
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Affiliation(s)
- Indu Arun
- 1 Tata Medical Center, Kolkata, West Bengal, India
| | - Paromita Roy
- 1 Tata Medical Center, Kolkata, West Bengal, India
| | - Neeraj Arora
- 1 Tata Medical Center, Kolkata, West Bengal, India
| | | | - Reena Nair
- 1 Tata Medical Center, Kolkata, West Bengal, India
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Arora N, Mehta A, Ravichandran S, Arun I, Achari RB, Chakrapani A, Bhave SJ, Chandy M, Nair R. NK/T Cell Lymphoma: A Tertiary Centre Experience. Indian J Hematol Blood Transfus 2016; 33:69-73. [PMID: 28194059 DOI: 10.1007/s12288-016-0675-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 03/31/2016] [Indexed: 11/25/2022] Open
Abstract
Extranodal NK/T-cell lymphoma (ENKTL), nasal type, is a rare type of non-Hodgkin lymphoma that is commonly seen in East Asian countries and is associated with Epstein-Barr virus infection. This is a retrospective study where we describe nine cases of ENKTL; nasal type diagnosed and treated at our center over a period of 2 years. These cases were analyzed retrospectively for clinical presentation (age, sex, site of involvement), immunophenotype, treatment, response and toxicity profile. Sino-nasal symptoms (blocked nose, headache, epistaxis, regurgitation) were the most common presenting complaints (n = 8). Almost 67 % (n = 6/9) of the cases were referred from Bhutan. Necrosis and angiocentricity were the commonest histological features. Depending on the stage of the disease patient were initially treated with chemotherapy (SMILE/CHOP) and Radiotherapy (IFRT). We describe our experience of management of ENKTL, where we observe that Bhutan could be endemic region for this rare tumour.
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Affiliation(s)
- Neeraj Arora
- Department of Laboratory Haematology & Molecular Genetics, Tata Medical Center, Kolkata, India
| | - Arpan Mehta
- Department of Laboratory Haematology & Molecular Genetics, Tata Medical Center, Kolkata, India
| | | | - Indu Arun
- Department of Pathology, Tata Medical Center, Kolkata, India
| | - Rimpa Basu Achari
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | - Anupam Chakrapani
- Department of Clinical Haematology, Tata Medical Center, Kolkata, India
| | | | - Mammen Chandy
- Department of Clinical Haematology, Tata Medical Center, Kolkata, India
| | - Reena Nair
- Department of Clinical Haematology, Tata Medical Center, Kolkata, India
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Radhakrishnan VS, Goel G, Das D, Ravichandran S, Khushoo V, Bhave SJ, Chakrapani A, Nair R, Bhattacharya S, Chandy M. Prevalence of antibiotic resistant strains in fecal surveillance cultures of patients from a new tertiary care cancer center in eastern part of India. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.e20686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e20686 Background: Drug resistant organisms are a very common cause of infections in critically ill patients in India. Surveillance Cultures is part of a multi-factorial approach to control MDRO[Multi-Drug Resistant Organisms]. Colonization surveillance may have the potential to improve empiric antimicrobial treatment in a critical care setting. Methods: Design: Retrospective. Setting: Newly started Comprehensive Cancer Center in Eastern part of India. Period: Dec 2011 - Jan 2013. Review of fecal surveillance cultures of patients undergoing intensive chemotherapy for hematological cancers or haemopoietic stem cell transplant. Fecal Surveillance cultures were done prior to Intensive Chemotherapy using a method based on Landman D et al (J Clin Microbiol 2005). Results: 48 patients [35 male,13 female] admitted with diagnoses of AML(22), ALL(6), APL(1), Acute Mixed Lineage Leukemia(1), MDS(1), Hodgkin Lymphoma(1), DLBCL(1), Fanconi Anemia(1), Multiple Myeloma(4), and Myeloproliferative Disorder(1) had information on Fecal Surveillance Cultures. Mean age: 35yrs [range; Male: 6-67yrs, Female:10-59yrs]. Total Samples collected: 67. Median sample per pateint: 1(range 1-4). All samples excepting one, grew MDRO isolates (98.5%). No. of Isolates:136 [95 gram negative bacilli (GNB), 41 gram positive cocci (GPC)]. Among GPC isolates, resistance to Ampicillin, Vancomycin, High level Gentamycin, and Linezolid were 86.5% (32/37), 7.3%(3/41), 60.9%(25/41) and nil(0/41) respectively. Among GNB isolates, resistance to Cefotaxime, Ciprofloxacin, Co-Amoxiclav, Gentamycin, Amikacin, Piperacillin-Tazobactum, Meropenem and Colistin were respectively 90.8%(79/87), 67.4%(60/89), 67.4%(60/89), 45.2%(43/95), 23.4%(22/94), 39.7%(37/93), 25.8%(24/93) and 6.4%(5/78). In the coliform group, the prevalence of ESBL/Amp-C producing isolates was 91.7%. Carbapenamase production was noted in 25.8% of GNB isolates. Conclusions: There is a very high prevalence of background antimicrobial resistance in the enteric flora of patients receiving intensive chemotherapy at our center. The causes of widespread MDRO in our setting needs further studies.
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Radhakrishnan VS, Chandy M, Bhattacharya S, Bhave SJ, Chakrapani A. Microbiology in Patients Undergoing Stem Cell Transplantation in the First Year of a Tertiary Care Comprehensive Cancer Centre From India. Biol Blood Marrow Transplant 2013. [DOI: 10.1016/j.bbmt.2012.11.370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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