Risk factor analysis of blood stream infection and pneumonia in neutropenic patients after peripheral blood stem-cell transplantation.
The purpose of this study was to analyse risk factors for blood stream infection (BSI) and pneumonia in neutropenic patients who have undergone peripheral blood stem-cell transplantation (PBSCT). Data were taken from the ONKO-KISS multicenter surveillance project. Infections were identified using CDC definitions (laboratory-confirmed BSI) and modified criteria for pneumonia in neutropenic patients. The multivariate analysis was performed using the Fine-Gray regression model for the cumulative incidences of the competing events 'infection', 'death' and 'end of neutropenia'. The risk factors investigated were: sex, age, underlying disease and type of transplant. From January 2000 to June 2004, a total of 1699 patients in 20 hospitals were investigated. In the multivariate analysis, male patients had a significantly higher risk of acquiring BSI than female patients (P=0.002). The risk of acquiring BSI is highest in patients with advanced acute myeloid leukaemia (AML). In the univariate and multivariate analysis, unrelated donor allogeneic transplantation constituted a risk factor for pneumonia (P=0.012). ONKO-KISS provides reference data on the incidence of pneumonia and BSI. The increased risk for BSI in males and patients with advanced AML, and the increased risk for pneumonia in unrelated donor allogeneic PBSCT patients should be targeted to prevent infections in these higher risk groups.
Meyer
E
E
Institute of Environmental Medicine and Hospital Epidemiology, Freiburg University Hospital, Freiburg, Germany. elisabeth.meyer@uniklinik-freiburg.de
Beyersmann
J
J
Bertz
H
H
Wenzler-Röttele
S
S
Babikir
R
R
Schumacher
M
M
Daschner
F D
FD
Rüden
H
H
Dettenkofer
M
M
D000208:Acute Disease; D003625:Data Collection; D005260:Female; D006801:Humans; D015994:Incidence; D007239:Infections / Q000209:etiology*; D007951:Leukemia, Myeloid / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009503:Neutropenia / Q000209:etiology*; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D011014:Pneumonia / Q000209:etiology*; D012307:Risk Factors; D012737:Sex Factors; D014184:Transplantation, Homologous