title: Current trends of infectious complications following hematopoietic stem cell transplantation in a single center.
abstract: This study was to analyze the infectious complications after hematopoietic stem cell transplantation (HSCT) according to the recent changes of HSCT. Medical records of 379 adult patients who underwent HSCT consecutively at Catholic HSCT Center from January 2001 to December 2002 were reviewed retrospectively. Allogeneic HSCT accounted for 75.7% (287/379) and autologous HSCT for 24.3% (92/379). During pre-engraftment period, bacterial infection was predominant, and E. coli was still the most common organism. After engraftment, viral infection was predominant. The incidence of invasive fungal infection showed bimodal distribution with peak correlated with neutropenia and graft-versus-host disease (GVHD). The overall mortality and infection-related mortality rates according to 3 periods were as follows; during pre-engraftment, 3.16% (12/379) and 1.8% (7/379); during midrecovery period, 7.9% (29/367) and 4.1% (15/367); during late-recovery period, 26.9% (91/338), and 15.9% (54/338). Risk factors for infection-related mortality were as follows; during pre-engraftment period, fungal infection and septic shock; during the mid-recovery period, hemorrhagic cystitis and delayed engraftment; during the late-recovery period, fungal infection, chronic GVHD, and relapse. In conclusion, infection was still one of the main complications after HSCT and highly contributes to mortality. The early diagnosis and the effective vaccination strategy are needed for control of infections.
authors.affiliation: Department of Internal Medicine, The Catholic Hematopoietic Stem Cell Transplantation Center, The Catholic University of Korea, College of Medicine, Seoul, Korea.
authors.forename: Sun Hee
authors.initials: SH
authors.lastname: Park
authors.forename: Su Mi
authors.initials: SM
authors.lastname: Choi
authors.forename: Dong Gun
authors.initials: DG
authors.lastname: Lee
authors.forename: Jung Hyun
authors.initials: JH
authors.lastname: Choi
authors.forename: Jin Hong
authors.initials: JH
authors.lastname: Yoo
authors.forename: Jong Wook
authors.initials: JW
authors.lastname: Lee
authors.forename: Woo Sung
authors.initials: WS
authors.lastname: Min
authors.forename: Wan Shik
authors.initials: WS
authors.lastname: Shin
authors.forename: Chun Choo
authors.initials: CC
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007239:Infections / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors