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Peer-reviewedCC BYFrontiers in cellular and infection microbiology

Rectal colonization with multidrug-resistant organisms in adult acute leukemia patients undergoing allogeneic hematopoietic stem cell transplantation: a retrospective, longitudinal, single-center study

  • Edoardo Tamellini1
  • Chiara Bonetto2
  • Annarita Mazzariol3
  • Fulvia Mazzaferri4
  • Erica Diani3
  • Francesca Tolio3
  • Sara Pagnin1
  • Alessandra Vatteroni1
  • Angela Crema1
  • Alberto Schena1
  • Cristina Tecchio1
4 affiliations
  1. 1Department of Engineering for Innovation Medicine, Innovation Biomedicine Section, Hematology and Bone Marrow Transplant Unit, University of Verona , ,
  2. 2Department of Neuroscience, Biomedicine and Movement Sciences, Psychiatry Section, University of Verona , ,
  3. 3Department of Diagnostics and Public Health, Microbiology Section, University of Verona , ,
  4. 4Department of Diagnostics and Public Health, Infective Disease Section, University of Verona , ,
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Abstract

Introduction: Rectal colonization with multidrug-resistant organisms (MDROs) represents a frequent issue in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) for acute leukemia. However, the prognostic significance of MDRO-colonization in these patients remains debated.

Methods: This retrospective, longitudinal, single-center study included 100 patients with acute myeloid or lymphoblastic leukemia treated at Verona University Hospital from diagnosis to allo-HSCT. MDRO-colonization was monitored by rectal swab at admission and weekly during hospitalization. Colonized patients underwent targeted antibiotic therapy when clinically required.

Aim of the study: To assess epidemiology, timing, and impact of rectal MDRO-colonization on infection occurrence, infection-related mortality (IRM) within day +100, overall survival (OS), and transplant-related mortality (TRM).

Results: Rectal colonization with 44 MDRO strains was detected in 35 (35%) patients undergoing allo-HSCT, either at hospital admission (45.7%) or during hospitalization (54.3%). Enterobacterales accounted for 72.7% of MDROs, with 68.5% of colonizing strains being detected during previous hospital stays for induction or consolidation therapies. MDRO-related bloodstream infections (BSI) occurred in 9 (9%) patients, 7 (77.8%) of whom being rectal carriers. IRM within day +100 was null. OS was significantly lower in MDRO-carriers as compared to non-carriers only at univariate analysis. TRM did not differ significantly between the two groups in both univariate and multivariate analyses.

Conclusion: Despite the limitations of a single-center retrospective study, our data show that careful monitoring of rectal colonization and prompt use of targeted antibiotics may temper the negative impact of MDRO-related infections in adult acute leukemia patients undergoing allo-HSCT, even in the setting of a higher rate of BSIs.

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Cite

BibTeXRIS
BibTeX
@article{tamellini2026rectal,
  title = {{Rectal colonization with multidrug-resistant organisms in adult acute leukemia patients undergoing allogeneic hematopoietic stem cell transplantation: a retrospective, longitudinal, single-center study}},
  author = {Edoardo Tamellini and Chiara Bonetto and Annarita Mazzariol and Fulvia Mazzaferri and Erica Diani and Francesca Tolio and Sara Pagnin and Alessandra Vatteroni and Angela Crema and Alberto Schena and Cristina Tecchio},
  journal = {Frontiers in cellular and infection microbiology},
  year = {2026},
  month = oct,
  doi = {10.3389/fcimb.2026.1902132},
  url = {https://europepmc.org/article/PMC/PMC13719380},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Rectal colonization with multidrug-resistant organisms in adult acute leukemia patients undergoing allogeneic hematopoietic stem cell transplantation: a retrospective, longitudinal, single-center study
AU  - Edoardo Tamellini
AU  - Chiara Bonetto
AU  - Annarita Mazzariol
AU  - Fulvia Mazzaferri
AU  - Erica Diani
AU  - Francesca Tolio
AU  - Sara Pagnin
AU  - Alessandra Vatteroni
AU  - Angela Crema
AU  - Alberto Schena
AU  - Cristina Tecchio
PY  - 2026
DA  - 2026/10/16
JO  - Frontiers in cellular and infection microbiology
DO  - 10.3389/fcimb.2026.1902132
UR  - https://europepmc.org/article/PMC/PMC13719380
AB  - Introduction: Rectal colonization with multidrug-resistant organisms (MDROs) represents a frequent issue in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) for acute leukemia. However, the prognostic significance of MDRO-colonization in these patients remains debated.  Methods: This retrospective, longitudinal, single-center study included 100 patients with acute myeloid or lymphoblastic leukemia treated at Verona University Hospital from diagnosis to allo-HSCT. MDRO-colonization was monitored by rectal swab at admission and weekly during hospitalization. Colonized patients underwent targeted antibiotic therapy when clinically required.  Aim of the study: To assess epidemiology, timing, and impact of rectal MDRO-colonization on infection occurrence, infection-related mortality (IRM) within day +100, overall survival (OS), and transplant-related mortality (TRM).  Results: Rectal colonization with 44 MDRO strains was detected in 35 (35%) patients undergoing allo-HSCT, either at hospital admission (45.7%) or during hospitalization (54.3%). Enterobacterales accounted for 72.7% of MDROs, with 68.5% of colonizing strains being detected during previous hospital stays for induction or consolidation therapies. MDRO-related bloodstream infections (BSI) occurred in 9 (9%) patients, 7 (77.8%) of whom being rectal carriers. IRM within day +100 was null. OS was significantly lower in MDRO-carriers as compared to non-carriers only at univariate analysis. TRM did not differ significantly between the two groups in both univariate and multivariate analyses.  Conclusion: Despite the limitations of a single-center retrospective study, our data show that careful monitoring of rectal colonization and prompt use of targeted antibiotics may temper the negative impact of MDRO-related infections in adult acute leukemia patients undergoing allo-HSCT, even in the setting of a higher rate of BSIs.
SN  - 2235-2988
ER  -