Abstract
Allogeneic and autologous peripheral blood stem cell transplants are frequently complicated by infections. This study was performed to evaluate early and late infections in 74 patients who underwent peripheral blood stem cell transplantation (PBSCT). Fifty-eight patients received allogeneic and 16 autologous PBSCT. All patients received fluconazole, ciprofloxacin and acyclovir prophylaxis. 93.1% of alloPBSCT patients and 87.5% of autoPBSCT patients developed fever. Febrile episodes were commonly seen in the week of transplantation (66%). There was a median of 3 days with fever in alloPBSCT, and 2 days in autoPBSCT. Period of neutropenia was 15 days for AlloPBSCT and 12 days for AutoPBSCT. The microbiological identification rate was 47% (32/68). Gram-positive infections dominated the early period (50%) and Gram-negative bacterial infections dominated the late period (50%). All our patients had Hickman-type catheters and 26 infections involving catheters were seen. Sixteen occurred in the early, and 10 in the late period. Ten of 14 (71.4%) late bacterial infections were catheter-related. The dominance of Gram-positive infections and high rates of methicillin resistance warranted the use of vancomycin extensively. Surveillance cultures were found to be useful in selected patients. Although slime factor is an important virulence factor, there was no difference between slime factor positive and negative coagulase-negative staphylococci isolated during infections. In conclusion, febrile episodes are the most frequent complication of PBSCT and Gram-positive microorganisms remain the main pathogen in these patients because of catheter use, mucositis and ciprofloxacin prophylaxis. Methicillin resistance is increasing and glycopeptides remain the only choice for treating such infections. Although the infection rate is high, measures taken to prevent and treat infections result in very low rates of mortality from infection in PBSCT patients. Bone Marrow Transplantation (2001) 27, 201–205.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Rent or buy this article
Prices vary by article type
from$1.95
to$39.95
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Kolbe K, Domkin D, Derigs HG et al. Infectious complications during neutropenia subsequent to peripheral blood stem cell transplantation Bone Marrow Transplant 1997 19: 143–147
Kirk Jl, Greenfield Ra, Slease B, Ebstein RB . Analysis of early infectious complications after autologous bone marrow transplantation Cancer 1988 62: 2445–2450
Baron EJ, Peterson LR, Finegold SM . Diagnostic Microbiology. Bailey and Scott's 9th edn CV Mosby Co: St Louis 1994 pp 321–405
Murray PR, Baron EJ, Pfaller MA et al. Manual of Clinical Microbiology 6th edn ASM Press: Washington DC 1995
Munro S . Disk diffusion susceptibility testing In: Isenberg HD, Hindler J (eds). Clinical Microbiology Procedures Handbook, Vol. 1 ASM Press: Washington DC 1992
NCCLS Performance Standards for Antimicrobial Disk Susceptibility Tests Vol. 17, document M2-A6, 6th edn Approved Standard Documents: Pennsylvania 1997
Freeman DJ, Falkiner FR, Reene CT . New method for detecting slime production by coagulase-negative staphylococci J Clin Pathol 1989 42: 872–874
Garner JS, Jarvis WR, Emori TG et al. CDC definitions for nosocomial infections Am J Infect Cont 1988 16: 128–140
Üstün C, Arslan Ö, Beksaç M et al. A retrospective comparison of allogeneic peripheral blood stem cell and bone marrow transplantation results from a single center, a focus on the incidence of GVHD and relapse Biol Blood Marrow Transplant 1999 5: 28–35
Bensinger WI, Weaver CH, Appelbaum FR et al. Transplantation of allogeneic peripheral blood stem cells mobilized by recombinant human granulocyte colony-stimulating factor Blood 1995 85: 1655–1668
Talmadge JE, Reed E, Ino K et al. Rapid immunologic reconstitution following transplantation with mobilized peripheral blood stem cells as compared to bone marrow Bone Marrow Transplant 1997 19: 161–172
Akan H, Koç H, Arslan Ö et al. Febrile neutropenia in a bone marrow transplantation unit Int J Antimicrob Agents 1997 16: 127–130
Çelebi H, Akan H, Aķçağlayan E et al. Febrile neutropenia in allogeneic and autologous peripheral blood stem cell transplantation and conventional chemotherapy for malignancies Bone Marrow Transplant 2000 26: 211–214
Sable CA, Donowitz GR . Infections in bone marrow transplant recipients Clin Infect Dis 1994 18: 273–281
Klastersky J, Zinner SH, Calandra T et al. Empirical antimicrobial therapy for febrile granulocytopenic cancer patients: lessons from four EORTC trials Eur J Cancer Clin Oncol 1988 24: S35–S45
Del Favero A, Bucaneve G, Menichetti F . Empiric monotherapy in neutropenia: a realistic goal? Scand J Infect Dis Suppl 1995 96: 34–37
Akova M . Kanser hastalarnda bakteriyel infeksiyonlara yaklasm ve empirik antimikrobiyal tedavi (approach to the bacterial infections in cancer patients and empirical treatment) Flora 1998 3: (Suppl. 1) 3–13
Wingard JR . Importance of Candida species other than C. albicans as pathogens in oncology patients Clin Infect Dis 1995 20: 115–125
Goodrich JM, Reed EC, Mori M et al. Clinical features and analysis of risk factors for invasive Candidal infection after marrow transplantation J Infect Dis 1991 164: 731–740
Verbist L . for the International Study Group Epidemiology and sensitivity of 8625 ICU and hematology/oncology bacterial isolates in Europe Scand J Infect Dis Suppl 1993 91: 14–24
Gür D, Ünal S ve çalyşma grubu . Yoğun bakym ünitelerinde izole edilen Gram negatif bakterilerin çeşitli antibiyotiklere invitro duyarliliklari (the in vitro susceptibility of Gram-negative bacteria to antibiotics isolated in ICU) Flora 1996 3: 153–159
Votava M, Woznicova V . Production of slime by staphylococcal isolates from blood cultures Cent Eur J Public Health 2000 8: 18–20
Arciola CR, Montanaro L, Baldassarri L et al. Slime production by Staphylococci isolated from prosthesis-associated infections New Microbiol 1999 22: 337–341
Perdreau-Remington F, Sande MA, Peters G, Chambers HF . The abilities of a Staphylococcus epidermidis wild-type strain and its slime-negative mutant to induce endocarditis in rabbits are comparable Infect Immun 1998 66: 2778–2781
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Aksu, G., Ruhi, M., Akan, H. et al. Aerobic bacterial and fungal infections in peripheral blood stem cell transplants. Bone Marrow Transplant 27, 201–205 (2001). https://doi.org/10.1038/sj.bmt.1702739
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.bmt.1702739
Keywords
This article is cited by
-
Invasive fungal infection among hematopoietic stem cell transplantation patients with mechanical ventilation in the intensive care unit
BMC Infectious Diseases (2012)
-
Antimicrobial therapy of febrile complications after high-dose chemotherapy and autologous hematopoietic stem cell transplantation—guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO)
Annals of Hematology (2012)
-
References
Bone Marrow Transplantation (2009)
-
Bacteremia after hematopoietic stem cell transplantation: incidence and predictive value of surveillance cultures
Bone Marrow Transplantation (2004)