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. 2021 Oct 12;11:752037. doi: 10.3389/fonc.2021.752037
Patient No. Broad-spectrum Antibiotics Defective Skin Barrier CRP(mg/dL) WBC(10³/µL) ANC(10³/µL) ICU Admission Mechanical Ventilation Concomitant BSI CVC Removal Antibiotic Treatment Total Duration of Treatment (days) Survival ***** Follow-up (days)
1 No Yes 3.5 8.2 0.7 No No No No Meropenem; moxifloxacin 14 Yes 2053
2 Yes Yes 11.3 27.5 21.7 Yes Yes Yes1 Yes TMP-SMX; meropenem;moxifloxacin; tigecyclin 20 Yes 395
3 Yes No 25.5 0.2 0 Yes Yes No No Meropenem; fosfomycin;tigecyclin 45 No 45
4 No No 19.8 0 0 Yes No No No Meropenem; ciprofloxacin 1 No 2
5 Yes Yes 37.9 0.3 0 Yes Yes Yes2 Yes TMP-SMX; meropenem 2 No 3
6 Yes No 6.1 0.7 0.2 No No No Yes Ceftazidim; colistin; moxifloxacin; tigecyclin 18 Yes 167
7 Yes No 23.0 0 0 No No No Yes Ceftazidim; colistin; moxifloxacin; tigecyclin 27 Yes 497
8 Yes Yes 3.3 0 0 Yes No No Yes Meropenem; colistin;moxifloxacin; tigecyclin 10 No 10
9 Yes No 9.7 0 0 No No No Yes Meropenem; ciprofloxacin 15 Yes 2446
10 Yes Yes 15.2 23.3 18.0 Yes Yes Yes3 Yes Ceftazidim; tobramycin 14 No 79

ALL, acute lymphoblastic leukemia; ANC, absolute neutrophil count; BSI, blood stream infection; CRP, C-reactive protein; CVC, central venous catheter; DSP, desmoplakin; EwS, Ewing sarcoma; F, female; HCT, hematopoetic stem cell transplantation; HLH, hemophagocytic lymphohistiocytosis; ICU, intensive care unit; IST, immunosuppressive therapy; M, male; MMUD, mismatched unrelated donor; MRD, matched related donor; MUD, matched unrelated donor; SCID, severe combined immunodeficiency; SM, Stenotrophomonas maltophilia; WBC, white blood cell count; VSAA, very severe aplastic anemia.

* Associated with recurrent infections, especially skin; care at the Department of Hematology and Oncology; * Conditions in allo-HCT recipients: Patient 1, chronic graft-versus-host disease (GVHD) of the skin, off immunosuppression, low dose steroids (< 0.3 mg/kg prednisone equivalent); patient 4, primary graft failure; patient 5, chronic GVHD of the skin and the gastrointestinal tract, immunosuppression with sirolimus, anti-inflammatory antibodies, methylprednisolone 2 mg/kg/d; patients 7 and 8 were prior to engraftment. ** including pulmonary hemorrhage (please see Figure 3 for details); * patient 1 had a catheter exit-site infection, and patient 8 had necrotizing fasciitis involving the lower extremities and buttocks. ** Four patients died in direct causal relationship to the infection from pulmonary hemorrhage (patients 3,4,5) and necrotizing fasciitis (patient 7) with multiorgan failure, and one patient (patient 10) died two months after completion of treatment from unrelated causes in hospice care.

1 Staphylococcus hemolyticus, Staphylococcus aureus, Enterococcus faecalis and Candida albicans in the week prior to diagnosis of S.maltophilia infection and another blood culture positive for Staphylococcus hemolyticus in the week after; 2 Escherichia coli, Enterococcus faecium, Staphylococcus epidermidis in the week prior to diagnosis of S.maltophilia infection; 3 Pseudomonas aeruginosa, Staphylococcus hemolyticus, and Enterococcus faecium in the week prior to diagnosis of S.maltophilia infection.