Outbreaks in hematopoietic stem cell transplant units: a systematic review.

IF 2.9 4区医学 Q2 INFECTIOUS DISEASES

Infection Control and Hospital Epidemiology Pub Date : 2025-04-21 DOI:10.1017/ice.2025.66

Loukas Kakoullis, Georges Chedid, Bradley Walker, Vasiliki Xirou, Sufian Abdel Hafez, Sokratis N Zisis, Shreya Arora, Costas A Christophi, George Panos, Courtney E Harris, Robert Colgrove

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引用次数: 0

Abstract

Objective: To identify and present the pathogens and sources of contamination linked to outbreaks within hematopoietic stem cell transplant (HSCT) units.

Design: Systematic review.

Setting: Inpatient HSCT units.

Methods: The PubMed/Medline databases were systematically searched as per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, employing the search terms "stem cell", "bone marrow", "transplant", "transplantation", "outbreak" and "pseudo-outbreak" from inception until July 31, 2024. Data on the type of event, pathogen involved, and source of contamination were extracted from eligible publications.

Results: In total, 39 studies including 387 patients were included in this review. The overall mortality rate was 23%. Pathogens identified included adenovirus, RSV, Pseudomonas aeruginosa, Aspergillus spp., and non-tuberculous mycobacteria (NTM). P. aeruginosa outbreaks were associated with contaminated sanitary fixtures (P = .007) and water (P = .039), outbreaks caused by NTM were associated with water (P = .009), while Aspergillus spp. outbreaks were associated with construction (P < .001). An index case was identified in 36.8% of viral outbreaks (P = .016). Other sources included inadequate disinfection and transmission from visitors.

Conclusions: Our study highlights several associations between pathogens involved in HSCT unit outbreaks and their respective sources. Establishing standardized guidelines for unit construction - particularly for ventilation and water safety - could further reduce the risk of pathogen transmission and enhance infection prevention in these high-risk settings.

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在造血干细胞移植单位暴发：系统回顾。

目的：鉴定和介绍与造血干细胞移植（HSCT）单位爆发有关的病原体和污染源。设计：系统回顾。环境：住院HSCT病房。方法：按照PRISMA （Preferred Reporting Items for Systematic Reviews and Meta-Analysis）指南对PubMed/Medline数据库进行系统检索，检索词为“stem cell”、“bone marrow”、“transplantation”、“transplantation”、“outbreak”和“pseudo-outbreak”，检索时间为成立之日至2024年7月31日。从符合条件的出版物中提取有关事件类型、涉及的病原体和污染源的数据。结果：本综述共纳入39项研究，包括387例患者。总死亡率为23%。鉴定的病原体包括腺病毒、RSV、铜绿假单胞菌、曲霉和非结核分枝杆菌（NTM）。铜绿假单胞菌暴发与污染的卫生设施（P = 0.007）和水（P = 0.039）有关，NTM引起的暴发与水（P = 0.009）有关，而曲霉菌暴发与建筑有关（P < 0.001）。36.8%的病毒暴发中存在指示病例（P = 0.016）。其他来源包括消毒不足和游客传播。结论：我们的研究强调了HSCT单位爆发的病原体及其各自来源之间的几种关联。建立标准化的单位建设指南——特别是通风和用水安全指南——可以进一步降低病原体传播的风险，并加强在这些高风险环境中的感染预防。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection Control and Hospital Epidemiology 医学-传染病学

CiteScore

6.40

自引率

6.70%

发文量

289

审稿时长

3-8 weeks

期刊介绍： Infection Control and Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. Written by infection control practitioners and epidemiologists and guided by an editorial board composed of the nation''s leaders in the field, ICHE provides a critical forum for this vital information.