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 6695); 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 250), while the median white blood cell count on admission was 1700 cells/ml (range 1005500/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 (14 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: 1.28651.235, 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 name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
|Back to top|