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Infections in patients with myelodysplastic syndromes

Abstract number: P1137

Kofteridis D.P., Stavroulaki A., Valachis A., Kalpadaki C., Tzanakakis M., Papadaki H.A., Samonis G.

Objectives: To describe clinical characteristics and outcome of infections in patients with myelodysplastic syndromes (MDS).

Patients and Methods: Infections occurring in patients with MDS, cared for at the University Hospital of Heraklion, Crete, Greece from 2004 to 2007 were retrospectively reviewed.

Results: Fifty four episodes of infection occurring in 32 patients have been studied. The median age of patients was 77 years (range 66–95); 24 (75%) were males. At the time of infection, 9 patients (28%) had been classified as RAEB-I, 7 (22%) as RA, 7 (22%) as RAEB-II, 4 (12.5%) as RCMD, while 3 (9%) and 2 (6%) as RARS and 5q(-) syndrome, respectively. The median length of hospital stay was 9.6 days (range 2–50), while the median white blood cell count on admission was 1700 cells/ml (range 100–5500/m). The most common was respiratory tract infection [27 episodes; (50%)], followed by urinary tract infection [7; (13%)]. Nine episodes were complicated by bacteraemia. The responsible microorganisms were identified in 19 (35%) of the episodes. The most frequently identified causative organisms were Staphylococcus epidermidis, isolated from 4 specimens (21%), Enterococcus faecalis from 4 (21%) and meticillin-resistant Staphylococcus aureus from 3 (16%). Regarding outcome, patients were classified into 2 groups: those with curable and those with complicated episodes. An episode was defined as complicated if responsible for the patient's death or prolonged hospitalisation (geqslant R: gt-or-equal, slanted14 days). There were 25 complicated episodes (46%) including 4 deaths (7%). The rest 29 episodes (54%) were curable. Univariate analysis showed a trend of patients with RAEB-I for complicated course as compared to patients with other MDS subtypes (P = 0.051), while patients with grade IV neutropenia (neutrophils <500/ml) developed infections significantly more frequently (P < 0.05). Multivariate logistic regression analysis revealed that grade IV neutropenia is associated with complicated course (OR: 8.306 95% CI: 1.286–51.235, P = 0.026).

Conclusions: Severe infections represent a serious threat for patients with MDS, especially those with grade IV neutropenia. Neutropenia and probably the MDS subtype may predict the relative risk.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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