Bacterial bloodstream infection in neutropenic adult patients after myeloablative cord blood transplantation: experience of a single institution in Japan.
Bacterial infection is one of the most important causes of morbidity and mortality after unrelated cord blood transplantation (CBT). In the present study, we studied 101 adult patients with respect to the incidence, outcome, and risk factors for bacterial bloodstream infection (BSI) within 30 days after CBT using a myeloablative conditioning regimen. Bacterial BSI occurred in 12 patients within 30 days after CBT. The cumulative incidence of bacterial BSI was 12%. The median time of onset was day +6 (range, day -1 to day +13) after CBT. In all patients, the neutrophil count was 0/microL at the onset of bacterial BSI. Eight (67%) and 4 (33%) of the isolates were Gram-positive and Gram-negative bacteria, respectively. Only 2 (17%) of the 12 patients who had bacterial BSI died within 100 days after CBT. No risk factors for the occurrence of bacterial BSI within 30 days after CBT were identified. The low mortality rate for bacterial BSI in the neutropenic period appeared to be associated with the low incidence (6%) of transplantation-related death at day +100 in our study patients. Early diagnosis of bacterial BSI and prompt treatment with effective antibiotics are necessary for neutropenic adult patients after myeloablative CBT.
Tomonari
Akira
A
Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan. atomonar@ims.u-tokyo.ac.jp
Takahashi
Satoshi
S
Ooi
Jun
J
Tsukada
Nobuhiro
N
Konuma
Takaaki
T
Kobayashi
Takeshi
T
Sato
Aki
A
Takasugi
Kashiya
K
Iseki
Tohru
T
Tojo
Arinobu
A
Asano
Shigetaka
S
D000293:Adolescent; D000328:Adult; D019072:Antibiotic Prophylaxis / Q000379:methods*; D016470:Bacteremia / Q000209:etiology* / Q000401:mortality* / Q000517:prevention & control; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects*; D003428:Cross Infection / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors; D019172:Transplantation Conditioning / Q000009:adverse effects*