Pathogenic Menace of MDR Bacteria in Stool and Throat Swab Surveillance Cultures of Hematopoietic Stem Cell Recipients and Evaluation of Post-Transplant Bloodstream Infections: A Cross-Sectional Study from A Tertiary Care Teaching Hospital of Kolkata, India

Kabita Choudhury; Sonia Deb; Suman Kundu; Baishali Dhar; Tuphan Kanti Dolai; Jayanta Bikash Dey; Swagata Ganguly Bhattacharjee

doi:10.55489/njmr.150120251035

Authors

Kabita Choudhury Department of Microbiology, Burdwan Medical College, Burdwan, India https://orcid.org/0000-0002-4438-4208
Sonia Deb Department of Microbiology, NRS Medical College, Kolkata, India https://orcid.org/0009-0002-2924-5442
Suman Kundu Department of Microbiology, NRS Medical College, Kolkata, India https://orcid.org/0000-0001-8861-7061
Baishali Dhar Department of Microbiology, NRS Medical College, Kolkata, India
Tuphan Kanti Dolai Department of Hematology, NRS Medical College, Kolkata, India https://orcid.org/0000-0002-4688-584X
Jayanta Bikash Dey Department of Microbiology, NRS Medical College, Kolkata, India
Swagata Ganguly Bhattacharjee Department of Microbiology, NRS Medical College, Kolkata, India https://orcid.org/0000-0002-5978-778X

DOI:

https://doi.org/10.55489/njmr.150120251035

Keywords:

Bone marrow cell transplantation, Stool surveillance culture, Drug Resistance, Bacteremia

Abstract

Background

Infections with multidrug-resistant organisms (MDRO) may pose a threat to hematopoietic stem cell transplant recipients. Pre-transplant surveillance culture of stool and throat swabs may guide antibiotic therapy in these groups of patients. We have conducted this study to determine the profile of organisms isolated from stool and throat swab cultures, their susceptibility pattern, and the presence of MDRO to detect post-transplant bloodstream infections in this tertiary care teaching hospital in Kolkata.

Methods

This cross-sectional study was conducted over a period of one year between 1^st January to 31^st December 2023. Pre-transplant surveillance culture of stool and throat swabs were performed on seventy patients from the Department of Hematology and processed in the Department of Microbiology using standard laboratory guidelines and their antibiotic susceptibility was done as per CLSI 2023 guidelines. The organisms were phenotypically screened for drug resistance and molecular confirmation was done for carbapenemases producers. Bloodstream infections in these recipients were detected by blood culture.

Results

There were 70 transplant recipients in whom stool surveillance culture yielded maximum incidence of Escherichia coli of which 32.8% were MDRO. Throat surveillance culture yielded Escherichia coli with 51.8% MDRO. bla_NDM was the most common carbapenemases gene detected. Post-transplant the incidence of bloodstream infections detected by blood culture was seen in 32 recipients with Acinetobacter baumannii being the predominant Gram-negative isolate.

Conclusion

Colonization with MDRO in HSCT recipients before transplant is a potential threat. Performing stool and throat surveillance cultures before transplantation can inform empirical antibiotic strategies and tailored individualized antibiotic treatment.

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