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2020, Number 1

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Rev Hematol Mex 2020; 21 (1)

Infectious processes in the transplantation of hematopoietic progenitor cells

García-Castillo C, Olaya-Vargas A, Pérez-García M, Melchor-Vidal YB, Cardoso-Yah G, Torres-Alarcón CG

Language: Spanish
References: 16
Page: 41-50
PDF size: 309.11 Kb.


ABSTRACT

Objective: To know the frequency and to identify the causative agents of infections in patients who received a transplant of hematopoietic progenitor cells in the transplant center of Centro Médico ABC Observatorio in Mexico City, in a period of 5 years (2009-2015).
Material and Method: A retrospective study was performed including patients who received a transplant of hematopoietic progenitor cells. All patients with febrile neutropenia who were taken cultures of one or several sites were registered. The presence of infection was recorded as well as the type of etiological agents, in an early post-transplant period that comprised the first 100 days.
Results: There were included 156 patients. Documented infectious processes represented 37.1% (n = 58), without differences in frequency by age group; infections were higher in patients who received as a source of cells to the bone marrow and umbilical cord blood in comparison with peripheral blood. The type of conditioning myeloablative was associated with the presentation of the infectious process. Twenty-five causal agents were identified; 81% of cases were due to bacteria. The infectious processes were presented in the pregraft stage up to 72.4% (n = 42).
Conclusions: The prevalence of infectious processes in hematopoietic progenitor cell transplantation was 37.2%, mostly due to endogenous gramnegative bacteria (E. coli) and negative coagulase staphylococci.


REFERENCES

  1. Wingard JR, Hsu J, Hiemenz JW. Hematopoietic stem cell transplantation: an overview of infection risks and epidemiology. Infect Dis Clin North Am 2010;24(2):257-272. doi: 10.1016/j.idc.2010.01.010.

  2. Balletto E, Mikulska M. Bacterial infections in hematopoietic stem cell transplant recipients. Mediterr J Hematol Infect Dis 2015;7(1):e2015045. Doi: 10.4084/ MJHID.2015.045.

  3. Pérez-García M, Olaya-Vargas A, Gaytán-Morales F, et al. Reconstitución inmunológica en niños receptores de trasplante de células progenitoras hematopoyéticas. Alergia, Asma e Inmunol Pediátricas 2012;21(2):72-79.

  4. Dykewicz CA. Summary of the Guidelines for Preventing Opportunistic Infections among Hematopoietic Stem Cell Transplant Recipients. Clin Infect Dis 2001;33(2):139-144. DOI: 10.1086/321805.

  5. Mikulska M, Del Bono V, Viscoli C. Bacterial infections in hematopoietic stem cell transplantation recipients. Curr Opin Hematol 2014;21(6):451-458. doi: 10.1097/ MOH.0000000000000088.

  6. Olaya Vargas A. Profilaxis y tratamiento de las infecciones por hongos y bacterias. In: Mexicanos E de textos, ed. Trasplante de células progenitoras hematopoyéticas en pediatría. 1ª ed. México, DF; 2012:516.

  7. Upton A, Kirby KA, Carpenter P, Boeckh M, Marr KA. Invasive aspergillosis following hematopoietic cell transplantation: Outcomes and prognostic factors associated with mortality. Clin Infect Dis 2007;44(4):531-540. DOI: 10.1086/510592.

  8. Lum SH, Miller WP, Jones S, et al. Changes in the incidence, patterns and outcomes of graft failure following hematopoietic stem cell transplantation for Hurler syndrome. Bone Marrow Transplant 2017;52:846. doi: 10.1038/bmt.2017.5.

  9. Olsson R, Remberger M, Schaffer M, et al. Graft failure in the modern era of allogeneic hematopoietic SCT. Bone Marrow Transplant 2012;48:537. DOI: 10.1038/bmt.2013.32.

  10. Pérez JL, Ayats J, Fortún J, de Oña M, Pumarola T. Microbiología del trasplante. Enferm Infecc Microbiol Clin 2011;29(9):683-690. DOI: 10.1016/j.eimc.2011.05.015.

  11. Montúfar Andrade FE, Madrid Muñoz CA, Villa Franco JP, et al. Bacteremia por Staphylococcus coagulasa negativo con concentración inhibitoria mínima para vancomicina ≥ 2. Infectio 2016;20(1):3-8. DOI: 10.1016/j.infect.2015.05.001.

  12. Rivas-Llamas JR. Neutropenia febril: el punto de vista del hematólogo. Gac Mex Oncol 2016;15(4):212-221. DOI: 10.1016/j.gamo.2016.07.005.

  13. Gorczynska E, Turkiewicz D, Rybka K, et al. Incidence, clinical outcome, and management of virus-induced hemorrhagic cystitis in children and adolescents after allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant 2005;11(10):797-804. DOI: 10.1016/j. bbmt.2005.06.007.

  14. Garcia-Vidal C, Upton A, Kirby KA, Marr KA. Epidemiology of invasive mold infections in allogeneic stem cell transplant recipients: biological risk factors for infection according to time after transplantation. Clin Infect Dis 2008;47(8):1041- 1050. doi: 10.1086/591969.

  15. Harrison N, Mitterbauer M, Tobudic S, et al. Incidence and characteristics of invasive fungal diseases in allogeneic hematopoietic stem cell transplant recipients: a retrospective cohort study. BMC Infect Dis 2015;15:584. doi: 10.1186/ s12879-015-1329-6.

  16. Samuel V, Eva B, Tomáš S, et al. The availability of HEPA‐filtered rooms and the incidence of pneumonia in patients after haematopoietic stem cell transplantation (HSCT): results from a prospective, multicentre, eastern European study. J Clin Nurs 2013;23(11-12):1648-1652. doi: 10.1111/ jocn.12286.




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