Lactose drives Enterococcus expansion to promote graft-versus-host disease. Vancomycin-resistant Enterococcus domination of intestinal microbiota is enabled by antibiotic treatment in mice and precedes bloodstream invasion in humans. Intestinal domination and the risk of bacteremia in patients undergoing allogeneic hematopoietic stem cell transplantation. Metagenomic analysis of the stool microbiome in patients receiving allogeneic stem cell transplantation: loss of diversity is associated with use of systemic antibiotics and more pronounced in gastrointestinal graft-versus-host disease.
Antibiotic-induced shifts in fecal microbiota density and composition during hematopoietic stem cell transplantation. Microbiota as predictor of mortality in allogeneic hematopoietic-cell transplantation. Micafungin versus fluconazole for prophylaxis against invasive fungal infections during neutropenia in patients undergoing hematopoietic stem cell transplantation.
CID EPISODE 1279 TRIAL
A controlled trial of fluconazole to prevent fungal infections in patients undergoing bone marrow transplantation. Efficacy and safety of fluconazole prophylaxis for fungal infections after marrow transplantation-a prospective, randomized, double-blind study. Guidelines for preventing infectious complications among hematopoietic cell transplantation recipients: a global perspective.
Infectious diseases in allogeneic haematopoietic stem cell transplantation: prevention and prophylaxis strategy guidelines 2016.
CID EPISODE 1279 UPDATE
Primary prophylaxis of invasive fungal infections in patients with haematological malignancies: 2017 update of the recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO). This expands our understanding of the clinical significance of the mycobiota and suggests that targeting fungal dysbiosis may help to improve long-term patient survival. These patients had worse overall survival and higher transplant-related mortality independent of candidaemia. They presented with distinct trans-kingdom microbiota profiles, characterized by a decreased intestinal bacterial biomass. We identified a subset of patients with fungal dysbiosis defined by culture positivity ( n = 53) and stable expansion of Candida parapsilosis complex species ( n = 19). We saw that the overall density and the biodiversity of intestinal fungi were stable during allo-HCT but the species composition changed drastically from day to day. Here we combined parallel high-throughput fungal ITS1 amplicon sequencing, bacterial 16S amplicon sequencing and fungal cultures of 1,279 faecal samples from a cohort of 156 patients undergoing allo-HCT to reveal potential trans-kingdom dynamics and their association with patient outcomes. The dynamics of intestinal fungi and their impact on clinical outcomes during allo-HCT are not fully understood. Nature Microbiology volume 6, pages 1505–1515 ( 2021) Cite this articleĪllogeneic haematopoietic cell transplantation (allo-HCT) induces profound shifts in the intestinal bacterial microbiota. Haematopoietic cell transplantation outcomes are linked to intestinal mycobiota dynamics and an expansion of Candida parapsilosis complex species
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