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Enterococcus Intestinal Domination is Associated with Increased Mortality in the Acute Leukemia Chemotherapy Population.
Messina, Julia A; Tan, Chin Yee; Ren, Yi; Hill, Lauren; Bush, Amy; Lew, Meagan; Andermann, Tessa; Peled, Jonathan U; Gomes, Antonio; van den Brink, Marcel R M; Chao, Nelson J; Surana, Neeraj K; Sung, Anthony D.
Afiliação
  • Messina JA; Division of Infectious Diseases, Department of Medicine, Duke University, Durham, USA.
  • Tan CY; Division of Infectious Diseases, Department of Pediatrics, Duke University, Durham, USA.
  • Ren Y; Department of Molecular Genetics and Microbiology, Duke University, Durham, USA.
  • Hill L; Duke Cancer Institute, Duke University, Durham, USA.
  • Bush A; Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Durham, USA.
  • Lew M; Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Durham, USA.
  • Andermann T; Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Durham, USA.
  • Peled JU; Division of Infectious Diseases, Department of Medicine, University of North Carolina, Chapel Hill, USA.
  • Gomes A; Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, USA.
  • van den Brink MRM; Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, USA.
  • Chao NJ; Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, USA.
  • Surana NK; Duke Cancer Institute, Duke University, Durham, USA.
  • Sung AD; Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Durham, USA.
Clin Infect Dis ; 2021 Dec 20.
Article em En | MEDLINE | ID: mdl-34928341
BACKGROUND: Enterococcus intestinal domination (EID), a state of dysbiosis wherein enterococci comprise ≥30% abundance within the microbiota, has been associated with Enterococcus bacteremia, graft-versus-host disease, and mortality in the allogeneic hematopoietic stem cell transplant (allo HCT) population. The acute leukemia (AL) chemotherapy population includes patients receiving intensive chemotherapy but do not all go on to have an allo HCT. The impact of EID on outcomes including mortality in the AL chemotherapy population is unknown. METHODS: Microbiota composition from weekly stool samples was analyzed by 16S ribosomal RNA gene sequencing. Patients were analyzed in 2 cohorts: AL chemotherapy cohort and allo HCT cohort. Alpha-diversity and richness were calculated. Kaplan Meier Analysis was used to analyze mortality. RESULTS: 929 stool samples were collected from 139 patients. Both allo HCT and AL cohorts had a decline in α-diversity and richness over the course of treatment that tends not to return to baseline months later. EID was observed in at least one sample in 36% of allo HCT patients and 49% of AL patients. Patients with observed EID had lower alpha-diversity over time. Similar to the HCT cohort, AL patients with EID had reduced overall survival. We identified 4 other genera that were commonly found in ≥30% relative abundance within the microbiota, but none were associated with mortality. In fact, in allo HCT, Bacteroides abundance ≥30% was associated with improved survival. CONCLUSIONS: EID is associated with increased all-cause mortality in HCT and AL cohorts. UnlikeEID, relative abundance ≥30% by other genera is not associated with increased all-cause mortality.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Risk_factors_studies Idioma: En Revista: Clin Infect Dis Assunto da revista: DOENCAS TRANSMISSIVEIS Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Risk_factors_studies Idioma: En Revista: Clin Infect Dis Assunto da revista: DOENCAS TRANSMISSIVEIS Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Estados Unidos