Clinical characteristics of study patients
| Variables . | Intestinal bacterial diversity,* postengraftment . | P value† . | ||
|---|---|---|---|---|
| High diversity (N = 26) . | Intermediate diversity (N = 20) . | Low diversity (N = 34) . | ||
| Pretransplant characteristics | ||||
| Age (years) | .671 | |||
| <35 | 4 (15.4%) | 3 (15.0%) | 6 (17.6%) | |
| 35-49 | 6 (23.1%) | 5 (25.0%) | 13 (38.2%) | |
| ≥50 | 16 (61.5%) | 12 (60.0%) | 15 (44.1%) | |
| Gender (female) | 13 (50.0%) | 6 (30.0%) | 16 (47.1%) | .346 |
| Underlying disease | .077 | |||
| Leukemia | 8 (30.8%) | 8 (40.0%) | 22 (64.7%) | |
| Lymphoma | 11 (42.3%) | 6 (30.0%) | 4 (11.8%) | |
| Multiple myeloma | 2 (7.7%) | 3 (15.0%) | 3 (8.8%) | |
| Myelodysplastic syndrome | 5 (19.2%) | 2 (10.0%) | 3 (8.8%) | |
| Other | 0 (0.0%) | 1 (5.0%) | 2 (5.9%) | |
| Pretransplant comorbidity (HCT-CI) | .121 | |||
| 0-1 | 15 (57.7%) | 7 (35.0%) | 8 (23.5%) | |
| 2-3 | 6 (23.1%) | 8 (40.0%) | 15 (44.1%) | |
| 4+ | 5 (19.2%) | 5 (25.0%) | 11 (32.4%) | |
| Disease risk (ASBMT RFI) | .388 | |||
| Low | 9 (34.6%) | 3 (15.0%) | 13 (38.2%) | |
| Intermediate | 6 (23.1%) | 4 (20.0%) | 7 (20.6%) | |
| High | 11 (42.3%) | 13 (65.0%) | 14 (41.2%) | |
| Transplant characteristics | ||||
| Conditioning intensity | .019 | |||
| Nonmyeloablative | 8 (30.8%) | 6 (30.0%) | 1 (2.9%) | |
| Reduced intensity | 7 (26.9%) | 7 (35.0%) | 12 (35.3%) | |
| Myeloablative | 11 (42.3%) | 7 (35.0%) | 21 (61.8%) | |
| Stem cell source | .168 | |||
| Related identical sibling | 11 (42.3%) | 9 (45.0%) | 9 (26.5%) | |
| Unrelated identical | 11 (42.3%) | 3 (15.0%) | 11 (32.4%) | |
| Unrelated nonidentical | 2 (7.7%) | 2 (10.0%) | 4 (11.8%) | |
| Umbilical cord | 2 (7.7%) | 6 (30.0%) | 10 (29.4%) | |
| T-cell depletion (ex-vivo) | 11 (42.3%) | 8 (40.0%) | 17 (50.0%) | .744 |
| Transplant course | ||||
| Time to engraftment (≥14 days posttransplant) | 3 (11.5%) | 6 (30.0%) | 10 (29.4%) | .197 |
| Ursodeoxycholic acid‡ | 3 (11.5%) | 5 (25.0%) | 9 (26.5%) | .328 |
| Liver dysfunction (total bilirubin > twice baseline) | 3 (11.5%) | 2 (10.0%) | 5 (14.7%) | 1.000 |
| Acute kidney injury (creatinine > twice baseline) | 2 (7.7%) | 5 (25.0%) | 15 (44.1%) | .006 |
| TPN‡ | 17 (65.4%) | 13 (65.0%) | 29 (85.3%) | .133 |
| Antibiotic‡ | ||||
| Vancomycin (intravenous) | 20 (76.9%) | 18 (90.0%) | 34 (100.0%) | .007 |
| Fluoroquinolone§ | 7 (26.9%) | 5 (25.0%) | 10 (29.4%) | 1.000 |
| Metronidazole | 4 (15.4%) | 4 (20.0%) | 15 (44.1%) | .031 |
| β-lactam¶ | 17 (65.4%) | 18 (90.0%) | 33 (97.1%) | .002 |
| Infection‡ | ||||
| C difficile infection | 1 (3.8%) | 1 (5.0%) | 12 (35.3%) | .002 |
| Gram-negative bloodstream infection | 1 (3.8%) | 3 (15.0%) | 6 (17.6%) | .262 |
| VRE bloodstream infection | 1 (3.8%) | 0 (0.0%) | 3 (8.8%) | .454 |
| Variables . | Intestinal bacterial diversity,* postengraftment . | P value† . | ||
|---|---|---|---|---|
| High diversity (N = 26) . | Intermediate diversity (N = 20) . | Low diversity (N = 34) . | ||
| Pretransplant characteristics | ||||
| Age (years) | .671 | |||
| <35 | 4 (15.4%) | 3 (15.0%) | 6 (17.6%) | |
| 35-49 | 6 (23.1%) | 5 (25.0%) | 13 (38.2%) | |
| ≥50 | 16 (61.5%) | 12 (60.0%) | 15 (44.1%) | |
| Gender (female) | 13 (50.0%) | 6 (30.0%) | 16 (47.1%) | .346 |
| Underlying disease | .077 | |||
| Leukemia | 8 (30.8%) | 8 (40.0%) | 22 (64.7%) | |
| Lymphoma | 11 (42.3%) | 6 (30.0%) | 4 (11.8%) | |
| Multiple myeloma | 2 (7.7%) | 3 (15.0%) | 3 (8.8%) | |
| Myelodysplastic syndrome | 5 (19.2%) | 2 (10.0%) | 3 (8.8%) | |
| Other | 0 (0.0%) | 1 (5.0%) | 2 (5.9%) | |
| Pretransplant comorbidity (HCT-CI) | .121 | |||
| 0-1 | 15 (57.7%) | 7 (35.0%) | 8 (23.5%) | |
| 2-3 | 6 (23.1%) | 8 (40.0%) | 15 (44.1%) | |
| 4+ | 5 (19.2%) | 5 (25.0%) | 11 (32.4%) | |
| Disease risk (ASBMT RFI) | .388 | |||
| Low | 9 (34.6%) | 3 (15.0%) | 13 (38.2%) | |
| Intermediate | 6 (23.1%) | 4 (20.0%) | 7 (20.6%) | |
| High | 11 (42.3%) | 13 (65.0%) | 14 (41.2%) | |
| Transplant characteristics | ||||
| Conditioning intensity | .019 | |||
| Nonmyeloablative | 8 (30.8%) | 6 (30.0%) | 1 (2.9%) | |
| Reduced intensity | 7 (26.9%) | 7 (35.0%) | 12 (35.3%) | |
| Myeloablative | 11 (42.3%) | 7 (35.0%) | 21 (61.8%) | |
| Stem cell source | .168 | |||
| Related identical sibling | 11 (42.3%) | 9 (45.0%) | 9 (26.5%) | |
| Unrelated identical | 11 (42.3%) | 3 (15.0%) | 11 (32.4%) | |
| Unrelated nonidentical | 2 (7.7%) | 2 (10.0%) | 4 (11.8%) | |
| Umbilical cord | 2 (7.7%) | 6 (30.0%) | 10 (29.4%) | |
| T-cell depletion (ex-vivo) | 11 (42.3%) | 8 (40.0%) | 17 (50.0%) | .744 |
| Transplant course | ||||
| Time to engraftment (≥14 days posttransplant) | 3 (11.5%) | 6 (30.0%) | 10 (29.4%) | .197 |
| Ursodeoxycholic acid‡ | 3 (11.5%) | 5 (25.0%) | 9 (26.5%) | .328 |
| Liver dysfunction (total bilirubin > twice baseline) | 3 (11.5%) | 2 (10.0%) | 5 (14.7%) | 1.000 |
| Acute kidney injury (creatinine > twice baseline) | 2 (7.7%) | 5 (25.0%) | 15 (44.1%) | .006 |
| TPN‡ | 17 (65.4%) | 13 (65.0%) | 29 (85.3%) | .133 |
| Antibiotic‡ | ||||
| Vancomycin (intravenous) | 20 (76.9%) | 18 (90.0%) | 34 (100.0%) | .007 |
| Fluoroquinolone§ | 7 (26.9%) | 5 (25.0%) | 10 (29.4%) | 1.000 |
| Metronidazole | 4 (15.4%) | 4 (20.0%) | 15 (44.1%) | .031 |
| β-lactam¶ | 17 (65.4%) | 18 (90.0%) | 33 (97.1%) | .002 |
| Infection‡ | ||||
| C difficile infection | 1 (3.8%) | 1 (5.0%) | 12 (35.3%) | .002 |
| Gram-negative bloodstream infection | 1 (3.8%) | 3 (15.0%) | 6 (17.6%) | .262 |
| VRE bloodstream infection | 1 (3.8%) | 0 (0.0%) | 3 (8.8%) | .454 |
Measured by inverse Simpson index: high diversity, >4; intermediate diversity, 2 to 4; low diversity, <2.
P values are 2-sided and based on Fisher’s exact test.
Evaluated during pre-engraftment period prior to specimen collection.
Fluoroquinolone antibiotics consist of ciprofloxacin and levofloxacin.
β-lactams include cephalosporins, β-lactam-β-lactamase combinations, and carbapenems.