{"id":{"repo_id":"washington","oai_identifier":"oai:digital.lib.washington.edu:1773/26483"},"canonical_url":"https://search.dev.ndltd.org/etd/washington/oai:digital.lib.washington.edu:1773/26483","repository":{"repo_id":"washington","name":"University of Washington","base_url":"https://digital.lib.washington.edu/server/oai/request"},"display":{"title":"Incidence rate of fluoroquinolone resistant gram-negative rod bacteremia among allogeneic hematopoietic cell transplant patients during an era of levofloxacin prophylaxis","abstract":"<bold>Background:</bold> There are concerns that emerging resistance to fluoroquinolones (FQ) may be leading to increasing rates of gram-negative rod (GNR) bacteremia in hematopoietic cell transplant (HCT) recipients. We set out to describe time trends in the incidence rates (IR) of GNR bacteremia and FQ-resistant GNR bacteremia in HCT recipients during an era of levofloxacin prophylaxis. <bold>Methods:</bold> We conducted a retrospective cohort study of adults undergoing allogeneic HCT between 2003 and 2012 at the Seattle Cancer Care Alliance (SCCA). Annual trends in the IRs of GNR bacteremia and FQ-resistant GNR bacteremia through 100 days post-transplant were assessed using Poisson regression. Cox proportional hazards regression was used to compare 30-day mortality between patients with FQ-resistant and those with FQ-sensitive GNR bacteremia. <bold>Results:</bold> Of the 2306 patients included in this cohort, 283 (12.3%) had GNR bacteremia. The IRs of GNR bacteremia and FQ-resistant GNR bacteremia increased from 2003 to 2009 and decreased afterwards; however, the overall annual trends were not significant (Incidence rate ratio [IRR] =1.01; 95% confidence interval [CI]: 0.98, 1.05 and IRR=1.03; 95% CI: 0.97, 1.10, respectively). FQ-resistant GNR bacteremia was associated with increased mortality compared to FQ-sensitive GNR bacteremia, even after adjustment for underlying disease severity, conditioning regimen, and age at transplant (Hazard ratio=2.31; 95% CI: 1.16, 4.62).<bold> Conclusions:</bold> On average, rates of FQ-resistant GNR bacteremia have not significantly changed at the SCCA over 10 years of FQ prophylaxis, although FQ-resistant GNR bacteremia is associated with increased mortality compared to FQ-sensitive GNR bacteremia.","abstract_html":"&lt;bold&gt;Background:&lt;/bold&gt; There are concerns that emerging resistance to fluoroquinolones (FQ) may be leading to increasing rates of gram-negative rod (GNR) bacteremia in hematopoietic cell transplant (HCT) recipients. We set out to describe time trends in the incidence rates (IR) of GNR bacteremia and FQ-resistant GNR bacteremia in HCT recipients during an era of levofloxacin prophylaxis. &lt;bold&gt;Methods:&lt;/bold&gt; We conducted a retrospective cohort study of adults undergoing allogeneic HCT between 2003 and 2012 at the Seattle Cancer Care Alliance (SCCA). Annual trends in the IRs of GNR bacteremia and FQ-resistant GNR bacteremia through 100 days post-transplant were assessed using Poisson regression. Cox proportional hazards regression was used to compare 30-day mortality between patients with FQ-resistant and those with FQ-sensitive GNR bacteremia. &lt;bold&gt;Results:&lt;/bold&gt; Of the 2306 patients included in this cohort, 283 (12.3%) had GNR bacteremia. The IRs of GNR bacteremia and FQ-resistant GNR bacteremia increased from 2003 to 2009 and decreased afterwards; however, the overall annual trends were not significant (Incidence rate ratio [IRR] =1.01; 95% confidence interval [CI]: 0.98, 1.05 and IRR=1.03; 95% CI: 0.97, 1.10, respectively). FQ-resistant GNR bacteremia was associated with increased mortality compared to FQ-sensitive GNR bacteremia, even after adjustment for underlying disease severity, conditioning regimen, and age at transplant (Hazard ratio=2.31; 95% CI: 1.16, 4.62).&lt;bold&gt; Conclusions:&lt;/bold&gt; On average, rates of FQ-resistant GNR bacteremia have not significantly changed at the SCCA over 10 years of FQ prophylaxis, although FQ-resistant GNR bacteremia is associated with increased mortality compared to FQ-sensitive GNR bacteremia.","abstract_has_math":false,"creators":["Miles-Jay, Arianna"],"institution":null,"degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Rowhani-Rahbar, Ali"],"committee_chairs":[],"committee_members":[],"year":2014,"date_issued":"2014-10-13","date_published":"2014-10-13","updated_at":"2026-07-24T05:58:01Z","subjects":["fluoroquinolone; gram-negative; neutropenia; prophylaxis; transplant"],"languages":["en_US"],"rights":["Copyright is held by the individual authors."],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://hdl.handle.net/1773/26483","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Rowhani-Rahbar, Ali"]},{"key":"dc:creator","label":"Author","values":["Miles-Jay, Arianna"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2014-10-13T20:04:01Z"]},{"key":"dc:date.issued","label":"Date","values":["2014-10-13"]},{"key":"dc:type","label":"Dc Type","values":["Thesis"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["fluoroquinolone; gram-negative; neutropenia; prophylaxis; transplant"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language.iso","label":"Language (ISO)","values":["en_US"]},{"key":"dc:rights","label":"Dc Rights","values":["Copyright is held by the individual authors."]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.other","label":"Dc Identifier Other","values":["MilesJay_washington_0250O_12962.pdf"]},{"key":"dc:identifier.uri","label":"Identifier URI","values":["http://hdl.handle.net/1773/26483"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["Thesis (Master's)--University of Washington, 2014"]},{"key":"dc:description.abstract","label":"Abstract","values":["<bold>Background:</bold> There are concerns that emerging resistance to fluoroquinolones (FQ) may be leading to increasing rates of gram-negative rod (GNR) bacteremia in hematopoietic cell transplant (HCT) recipients. We set out to describe time trends in the incidence rates (IR) of GNR bacteremia and FQ-resistant GNR bacteremia in HCT recipients during an era of levofloxacin prophylaxis. <bold>Methods:</bold> We conducted a retrospective cohort study of adults undergoing allogeneic HCT between 2003 and 2012 at the Seattle Cancer Care Alliance (SCCA). Annual trends in the IRs of GNR bacteremia and FQ-resistant GNR bacteremia through 100 days post-transplant were assessed using Poisson regression. Cox proportional hazards regression was used to compare 30-day mortality between patients with FQ-resistant and those with FQ-sensitive GNR bacteremia. <bold>Results:</bold> Of the 2306 patients included in this cohort, 283 (12.3%) had GNR bacteremia. The IRs of GNR bacteremia and FQ-resistant GNR bacteremia increased from 2003 to 2009 and decreased afterwards; however, the overall annual trends were not significant (Incidence rate ratio [IRR] =1.01; 95% confidence interval [CI]: 0.98, 1.05 and IRR=1.03; 95% CI: 0.97, 1.10, respectively). FQ-resistant GNR bacteremia was associated with increased mortality compared to FQ-sensitive GNR bacteremia, even after adjustment for underlying disease severity, conditioning regimen, and age at transplant (Hazard ratio=2.31; 95% CI: 1.16, 4.62).<bold> Conclusions:</bold> On average, rates of FQ-resistant GNR bacteremia have not significantly changed at the SCCA over 10 years of FQ prophylaxis, although FQ-resistant GNR bacteremia is associated with increased mortality compared to FQ-sensitive GNR bacteremia."]},{"key":"dc:format.mimetype","label":"Dc Format Mimetype","values":["application/pdf"]},{"key":"dc:title","label":"Title","values":["Incidence rate of fluoroquinolone resistant gram-negative rod bacteremia among allogeneic hematopoietic cell transplant patients during an era of levofloxacin prophylaxis"]}]}],"canonical_facts":{"dc:contributor.advisor":["Rowhani-Rahbar, Ali"],"dc:creator":["Miles-Jay, Arianna"],"dc:date.accessioned":["2014-10-13T20:04:01Z"],"dc:date.issued":["2014-10-13"],"dc:description":["Thesis (Master's)--University of Washington, 2014"],"dc:description.abstract":["<bold>Background:</bold> There are concerns that emerging resistance to fluoroquinolones (FQ) may be leading to increasing rates of gram-negative rod (GNR) bacteremia in hematopoietic cell transplant (HCT) recipients. We set out to describe time trends in the incidence rates (IR) of GNR bacteremia and FQ-resistant GNR bacteremia in HCT recipients during an era of levofloxacin prophylaxis. <bold>Methods:</bold> We conducted a retrospective cohort study of adults undergoing allogeneic HCT between 2003 and 2012 at the Seattle Cancer Care Alliance (SCCA). Annual trends in the IRs of GNR bacteremia and FQ-resistant GNR bacteremia through 100 days post-transplant were assessed using Poisson regression. Cox proportional hazards regression was used to compare 30-day mortality between patients with FQ-resistant and those with FQ-sensitive GNR bacteremia. <bold>Results:</bold> Of the 2306 patients included in this cohort, 283 (12.3%) had GNR bacteremia. The IRs of GNR bacteremia and FQ-resistant GNR bacteremia increased from 2003 to 2009 and decreased afterwards; however, the overall annual trends were not significant (Incidence rate ratio [IRR] =1.01; 95% confidence interval [CI]: 0.98, 1.05 and IRR=1.03; 95% CI: 0.97, 1.10, respectively). FQ-resistant GNR bacteremia was associated with increased mortality compared to FQ-sensitive GNR bacteremia, even after adjustment for underlying disease severity, conditioning regimen, and age at transplant (Hazard ratio=2.31; 95% CI: 1.16, 4.62).<bold> Conclusions:</bold> On average, rates of FQ-resistant GNR bacteremia have not significantly changed at the SCCA over 10 years of FQ prophylaxis, although FQ-resistant GNR bacteremia is associated with increased mortality compared to FQ-sensitive GNR bacteremia."],"dc:format.mimetype":["application/pdf"],"dc:identifier.other":["MilesJay_washington_0250O_12962.pdf"],"dc:identifier.uri":["http://hdl.handle.net/1773/26483"],"dc:language.iso":["en_US"],"dc:rights":["Copyright is held by the individual authors."],"dc:subject":["fluoroquinolone; gram-negative; neutropenia; prophylaxis; transplant"],"dc:title":["Incidence rate of fluoroquinolone resistant gram-negative rod bacteremia among allogeneic hematopoietic cell transplant patients during an era of levofloxacin prophylaxis"],"dc:type":["Thesis"]},"updated_at":"2026-07-24T05:58:01Z"}