Infections in patients with aplastic anemia: experience at a tertiary care cancer center.
BACKGROUND
Infection is a significant cause of death in patients with aplastic anemia (AA). However, few recent studies have examined infectious complications in patients with AA.


METHODS
The authors retrospectively evaluated the type of infections, associated pathogens, and outcome of infectious episodes (IEs) in patients with AA who were treated at The University of Texas M. D. Anderson Cancer Center between July 1994 and June 2000.


RESULTS
Fifty-two patients with a median age of 37 years (range, 3-83 years) were identified. Overall, 104 IEs were documented in 42 patients (81%). The most common microbiologically documented infections were bacteremias (38%) followed by pneumonias (16%). Most patients (55%) had bacterial infections, mainly caused by gram-positive cocci. Multidrug-resistant, gram-negative bacilli also were not uncommon in this patient population. Five of 12 patients who died during the study period died of infection. All of these patients had invasive fungal infections, mostly due to molds. All five patients had prolonged and severe neutropenia.


CONCLUSIONS
Infections remain a major cause of death in patients with AA. Bacterial infections, especially those caused by gram-positive cocci, constitute the main cause of IE. Invasive mold infections, however, are the major cause of death in this patient population.
Torres
Harrys A
HA
Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
Bodey
Gerald P
GP
Rolston
Kenneth V I
KV
Kantarjian
Hagop M
HM
Raad
Issam I
II
Kontoyiannis
Dimitrios P
DP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000741:Anemia, Aplastic / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D001424:Bacterial Infections / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000209:etiology / Q000401:mortality; D009503:Neutropenia / Q000209:etiology; D012189:Retrospective Studies; D016019:Survival Analysis
D007166:Immunosuppressive Agents