The Epidemiology of Multidrug-Resistant Pathogens in Hematopoietic Stem Cell Transplantation (HSCT) Patients: A...

Area of Science:

• Infectious Diseases
• Hematology
• Microbiology

Background:

• Multidrug-resistant (MDR) pathogens pose a severe threat to hematopoietic stem cell transplant (HSCT) recipients.
• Limited regional data exists on infection patterns and antimicrobial resistance in HSCT populations.
• Understanding these patterns is crucial for effective infection control and treatment strategies.

Purpose of the Study:

• To characterize the incidence of clinically confirmed bacterial infections in HSCT recipients.
• To determine the distribution of pathogens and antimicrobial resistance patterns.
• To provide regional data for the Middle East concerning MDR infections in HSCT patients.

Main Methods:

• Retrospective analysis of data from King Hussein Cancer Center, Jordan (2018-2022).
• Inclusion of 1157 HSCT procedures and analysis of 327 patients with bacterial infections.
• Definition of MDR pathogens according to CDC criteria; analysis of pathogen types and resistance mechanisms.

Main Results:

• Overall cumulative incidence of bacterial infections was 28.3%, higher in pediatric HSCT recipients (34.7%).
• Gram-negative bacteria predominated, with *Escherichia coli* and *Klebsiella pneumoniae* being most frequent.
• Extended-spectrum beta-lactamase (ESBL) production (71.3%) was the primary resistance mechanism, followed by carbapenem-resistant *Enterobacteriaceae* (CRE; 14.1%) and methicillin-resistant *Staphylococcus aureus* (MRSA; 8.6%).

Conclusions:

• Bacterial infections, particularly those caused by MDR pathogens, are a significant concern in HSCT recipients in the Middle East.
• ESBL-producing Gram-negative bacteria represent a major challenge, highlighting the need for targeted interventions.
• Findings underscore the importance of robust antimicrobial stewardship programs and infection control measures for this vulnerable population.