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Prospective study of infectious complications in a cohort of 54 consecutive allogeneic haematopoietic stem cell transplant recipients

Abstract number: P1144

Martín-Peña A., Aguilar-Guisado M., Espigado I., Parody R., Cisneros J.M.

Objectives: To determine the incidence, aetiology and mortality during the first 2 years after transplantation in allogeneic stem cell transplant recipients (allo-HSCT).

Methods: Prospective, observational study of a consecutive allo-HSCT adult recipients cohort, between July-03 and May-06. Descriptive analyses of infection and mortality.

Results: 54 consecutive allo-HSCT recipients were included, median age 40.5 years (16–58), 52% males. Median follow-up was 180 days (9–720). Eighty-two infections occurred in 41 patients. Incidence of infection was 1.4 episodes/patient during the first year and 2 episodes/patient during the first 2 years after transplantation. In the pre-engraftment period (PEP) the incidence of infection was 0.5 episodes/patient, in the mid recovery period (MRP) was 0.6 and in the late recovery period (LRP) 0.8. In the PEP there were 29 infections (35.4%), and the most frequent were catheter-related (34.5%), pneumonia (17.2%) and bacteraemia (17.2%). In the MRP there were 27 episodes (32.9%), the most frequent were CMV infection (42.3%), and primary bacteraemia (22.2%). In the LRP there were 26 episodes (31.7%), being the most frequent CMV infection (23.1%) and mucocutaneous infection (23.1%). Etiological diagnosis was established in 65/82 episodes (79.3%). Bacterial aetiology predominated (55.4%), followed by viral (40%) and fungal (4.6%). In the PEP Gram-positive bacteria were the most frequent aetiology (42.8%), followed by Gram-negative (33.3%). There were 2 invasive aspergillosis (9.5%). In the MRP Gram-negative bacteria predominated, together with viruses, all of them CMV (42.3%). In the LRP the most frequent aetiology were viruses (66.6%) mainly CMV (33.3%) followed by VHS (22.2.%). Thirteen patients died during the follow-up (24%) The mortality rate by periods was: 5.5% (PEP), 11.8% (MRP) and 8.9% (LRP). Death was infection-related in six cases (46%).

Conclusions: The incidence of infection after allo-HSCT is high and reaches 2 episodes per patient up to 2 years after transplantation. The most frequent infections in the pre-engraftment period are catheter-related and pneumonia, whereas in mid and late recovery periods is CMV infection. The most frequent aetiology are bacteria, but viruses increase in frequency along the recovery periods and are the most frequent in the late recovery period. Mortality is high, and predominantly related to infection.

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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