339 Enteric colonization with fluoroquinolone-resistant Enterobacterales is associated with increased Enterobacterales and Bacteroidales in hematopoietic cell transplant recipients prior to transplantation
Abstract
Objectives/Goals: Our objectives were to determine enteric microbiome characteristics in fluoroquinolone-resistant Enterobacterales (FQRE)-colonized and non-FQRE-colonized hematopoietic cell transplant (HCT recipients, and to understand the enteric microbiome-specific factors associated with the development of FQRE BSI in FQRE-colonized HCT recipients. Methods/Study Population: This was a prospective cohort study of patients undergoing HCT at Weill Cornell Medicine from November 2016 to August 2019. All participants received levofloxacin prophylaxis during post-HCT neutropenia. Stool samples were collected prior to levofloxacin prophylaxis initiation and during the week after HCT. Our overall study population consisted of 26 FQRE-colonized HCT recipients and 69 non-FQRE-colonized HCT recipients. Samples underwent selective quantitative culture for FQRE, as well as 16S rRNA sequencing. Raw sequence data were processed and aligned to a custom SILVA database. Analysis of 16S rRNA sequencing was conducted in R using phyloseq. Results/Anticipated Results: We saw significant differences in microbiome composition in comparing pre-HCT samples from FQRE-colonized HCT recipients to non-FQRE-colonized HCT recipients, including significantly higher relative abundances of Bacteroidales and Enterobacterales in colonized recipients. MaAslin2 demonstrated significantly differential abundance of Bacteroides and Escherichia-Shigella ASVs. We observed a significant decrease in Enterobacterales…
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Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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