Bacterial infection in patients with transfusion-dependent beta-thalassemia in central Taiwan.
The microorganisms, outcome of infections and the risk factors were evaluated in 39 patients with beta-thalassemia who received frequent blood transfusions. Among these patients, thirteen developed 22 episodes of infections, and bacteremia accounted for 72.7% (16/22) of all infections. Three patients developed meningitis, two patients had liver abscesses, three patients had soft tissue infections, one patient had a urinary tract infection and one patient had lobar pneumonia. Interestingly, a large proportion of the patients were infected by Gram-negative bacteria. Patients who were implanted with intravascular catheters were most susceptible to bacterial infection (1.70 episodes/patient) (P = 0.0069). So were patients with ferritin levels over 2,000 ng/mL (1.18 episodes/patient) (P = 0.028). The frequency of bacterial infections in patients with splenectomies (1.08 episode/patient) was also significantly higher than that of the average patient (P = 0.025). In conclusion, three major risk factors for bacterial infection were identified in this group of patients: intravascular catheterization, high serum ferritin levels (> or = 2,000 ng/mL) and splenectomy. The infection rate of these patients (0.45 episode/100 patient-year) is about 20-fold higher than that of general pediatric patients (0.023 episode/100 patient-year).
Peng
C T
CT
Department of Pediatrics, China Medical College Hospital, Taichung, Taiwan.
Tsai
C H
CH
Wang
J H
JH
Chiu
C F
CF
Chow
K C
KC
D000293:Adolescent; D000328:Adult; D001424:Bacterial Infections / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005293:Ferritins / Q000097:blood; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000382:microbiology; D012307:Risk Factors; D013156:Splenectomy; D013624:Taiwan; D065227:Transfusion Reaction; D017086:beta-Thalassemia / Q000382:microbiology* / Q000628:therapy
D005293:Ferritins