Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Infections Post Transplant

Infections among allogeneic bone marrow transplant recipients in India

Bone Marrow Transplantation volume 33, pages 311–315 (2004)Cite this article

Summary:

Infections are a major cause of morbidity and mortality in patients undergoing high-dose therapy and allogeneic bone marrow transplantation (BMT) despite prophylaxis, use of growth factors and newer antimicrobial drugs. We report the clinical profile of infections among 297 patients who underwent 304 allogeneic transplants between 1986 and December 2001. All patients developed febrile neutropenia. There were 415 documented infections among 304 transplants. This included bacterial (34.9%), viral (42.9%), fungal (15.9%) and other infections (6.3%) including tuberculosis. Bacterial pathogens were mainly Gram-negative bacteria (80%) as compared to Gram-positive (20%) bacteria. The common Gram-negative bacteria were nonfermenting Gram-negative bacteria (NFGNB) (24.9%), Pseudomonas (17.9%), Escherichia coli (17.9%) and Klebsiella (9.7%). The major source of positive cultures was blood (53.7%) followed by urine (25.5%) and sputum (8.9%). In all, 133/304 (43.7%) transplants had 178 documented viral infections. The common viral infections were due to cytomegalovirus, herpes group of viruses and transfusion-related hepatitis; and 60/304 (19.7%) transplants had 66 documented fungal infections. Common fungi included Aspergillus species (69.7%), Candida (22.2%) and Zygomycetes (8.1%). Tuberculosis was documented in 2.3% of the transplants. Catheter infections were suspected or documented in 7.8% of the transplants (24/304). The incidence of infections in this series from developing countries is not significantly different from reports from the West.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Ascioglu S, Rex JH, de Pauw B et al. Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: international consensus. Clin Infect Dis 2002; 34: 7–14.

    Article  CAS  Google Scholar 

  2. Kruger W, Russmann B, Kroger N et al. Early infections in patients undergoing bone marrow or blood stem cell transplantation – a 7 year single center investigation of 409 cases. Bone Marrow Transplant 1999; 23: 589–597.

    Article  CAS  Google Scholar 

  3. Tomas JF, Hernandez LM, Penarrubia MJ et al. Early bacterial infections in 103 patients treated with bone marrow transplantation. Sangre (Barc) 1994; 39: 191–196.

    CAS  Google Scholar 

  4. Collin BA, Leather HL, Wingard JR et al. Evolution, incidence and susceptibility of bacterial bloodstream isolates from 519 bone marrow transplant patients. Clin Infect Dis 2001; 33: 947–953.

    Article  CAS  Google Scholar 

  5. Gupta S, Kumar L, Raju GM et al. Autologous bone marrow/stem cell transplantation: initial experience at a North Indian referral center. Natl Med J India 2000; 13: 61–66.

    CAS  PubMed  Google Scholar 

  6. Ghosh K, Shenoy AK, Al-Mahrooqi Z . Bacteriological infections during the first hundred days of allogeneic bone marrow transplantation – experience from Oman. J Assoc Physicians India 2002; 50: 910–912.

    PubMed  Google Scholar 

  7. Arns da Cunha C, Weisdorf D, Shu XO et al. Early gram positive bacteremia in BMT recipients: impact of three different approaches to antimicrobial prophylaxis. Bone Marrow Transplant 1998; 21: 173–180.

    Article  CAS  Google Scholar 

  8. Wingard JR . Viral infections in leukemia and bone marrow transplant patients. Leuk Lymphoma 1993; 11 (Suppl. 2): 115–125. (review).

    Article  Google Scholar 

  9. Kawasaki H, Takayama J, Ohira M . Herpes zoster infection after bone marrow transplantation in children. J Pediatr 1996; 128: 353–356.

    Article  CAS  Google Scholar 

  10. Ip MS, Yuen KY, Chiu EK et al. Pulmonary infections in bone marrow transplantation: the Hong Kong experience. Respiration 1995; 62: 80–83.

    Article  CAS  Google Scholar 

  11. Nomura F, Shimokata K, Sakai S et al. Cytomegalovirus pneumonitis occurring after allogeneic bone marrow transplantation: a study of 106 recipients. Jpn J Med 1990; 29: 595–602.

    Article  CAS  Google Scholar 

  12. Machado CM, Dulley FL, Vilas Boas et al. CMV pneumonia in allogeneic BMT recipients undergoing early treatment or pre-emptive ganciclovir therapy. Bone Marrow Transplant 2000; 26: 413–417.

    Article  CAS  Google Scholar 

  13. Einsele H, Ehninger G, Hebart H et al. Polymerase chain reaction monitoring reduces the incidence of cytomegalovirus disease and the duration and side effects of antiviral therapy after bone marrow transplantation. Blood 1995; 86: 2815–2820.

    CAS  Google Scholar 

  14. Ustun C, Koc H, Karayalcin S et al. Hepatitis B virus infection in allogeneic bone marrow transplantation. Bone Marrow Transplant 1997; 20: 289–293.

    Article  CAS  Google Scholar 

  15. Norol F, Roche B, Saint-Marc Girardin MF et al. Hepatitis C virus infection and allogeneic bone marrow transplantation. Bone Marrow Transplant 1995; 16: 407–410.

    Google Scholar 

  16. Ninin E, Milpied N, Moreau P et al. Study of bacterial, viral and fungal infections in adult recipients of bone marrow transplants. Clin Infect Dis 2001; 33: 41–47.

    Article  CAS  Google Scholar 

  17. Hovi L, Saarinen-Pihkala UM, Vettenranta K et al. Invasive fungal infections in pediatric bone marrow transplant recipients: single center experience of 10 years. Bone Marrow Transplant 2000; 26: 999–1004.

    Article  CAS  Google Scholar 

  18. Weinberger M, Sacks T, Sulkes J et al. Increasing fungal isolation from clinical specimens: experience in a university hospital over a decade. J Hosp Infect 1997; 35: 185–195.

    Article  CAS  Google Scholar 

  19. Martino R, Subaru M, Rovira M et al. Invasive fungal infections after allogeneic peripheral blood stem cell transplantation: incidence and risk factors in 395 patients. Br J Haematol 2002; 116: 475–482.

    Article  Google Scholar 

  20. Jantunen E, Ruutu P, Niskanen L et al. Incidence and risk factors for invasive fungal infections in allogeneic BMT recipients. Bone Marrow Transplant 1997; 19: 801–808.

    Article  CAS  Google Scholar 

  21. George B, Mathews V, Srivastava V et al. Tuberculosis among allogeneic bone marrow transplant recipients in India. Bone Marrow Transplant 2001; 27: 973–975.

    Article  CAS  Google Scholar 

  22. Budak-Alpdogan T, Tangun Y, Kalayoglu-Besisik S et al. The frequency of tuberculosis in adult allogeneic stem cell transplant recipients in Turkey. Biol Blood Marrow Transplant 2000; 6: 370–374.

    Article  CAS  Google Scholar 

  23. Mary S, Ip M, Yuen KY et al. Risk factors for pulmonary tuberculosis in bone marrow transplant recipients. Am J Respir Crit Care Med 1998; 158: 1173–1177.

    Article  Google Scholar 

  24. Roy V, Weisdorf D . Mycobacterial infections following bone marrow transplantation: a 20 year retrospective review. Bone Marrow Transplant 1997; 19: 467–470.

    Article  CAS  Google Scholar 

  25. Tuan IZ, Dennison D, Weisdorf DJ . Pneumocystis carinii pneumonitis following bone marrow transplantation. Bone Marrow Transplant 1992; 10: 267–272.

    CAS  PubMed  Google Scholar 

  26. Elishoov H, Or R, Strauss N et al. Nosocomial colonization, septicemia and Hickman/Broviac catheter-related infections in bone marrow transplant recipients. A 5-year prospective study. Medicine (Baltimore) 1998; 77: 83–101.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Haematology, Christian Medical College, Vellore, Tamil Nadu, India

    B George, V Mathews, A Srivastava & M Chandy

Authors
  1. B George
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. V Mathews
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A Srivastava
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M Chandy
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to B George.

Rights and permissions

Reprints and permissions

About this article

Cite this article

George, B., Mathews, V., Srivastava, A. et al. Infections among allogeneic bone marrow transplant recipients in India. Bone Marrow Transplant 33, 311–315 (2004). https://doi.org/10.1038/sj.bmt.1704347

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1704347

Keywords

This article is cited by

Search

Advanced search

Quick links