title: Pneumonia in allogeneic stem cell transplantation recipients: a multicenter prospective study.
abstract: Pneumonia is a common cause of mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT) but updated and prospective information is partial. The aim of this nationwide prospective study is to determine the current epidemiology, etiology, and outcome of pneumonia in allo-HSCT recipients. From September-2003 to November-2005, 112 episodes in 427 consecutive allo-HSCT recipients were included (incidence 52.2 per 100 allo-HSCT/yr), and 72 of them (64.3%) were microbiologically defined pneumonia. Bacterial pneumonia (44.4%) was more frequent than fungal (29.2%) and viral pneumonia (19.4%). The most frequent microorganisms in each group were: Escherichia coli (n = 7, 8.9%), Streptococcus pneumoniae (n = 4, 5.0%), cytomegalovirus (n = 12, 15.4%), and Aspergillus spp. (n = 12, 15.4%). The development of pneumonia and chronic graft-versus-host disease (GVHD) was associated with increased mortality after allo-HSCT, and the probability of survival was significantly lower in patients that had at least one pneumonia episode (p < 0.01). Pneumonia development in the first 100 d after transplantation, fungal etiology, GVHD, acute respiratory failure, and septic shock were associated with increased mortality after pneumonia. Our results show that pneumonia remains a frequent infectious complication after allo-HSCT, contributing to significant mortality, and provide a large current experience with the incidence, etiology and outcome of pneumonia in these patients.
authors.affiliation: Hospital Virgen del Rocío, Sevilla, Spain. maguilarguisado@yahoo.es
authors.forename: Manuela
authors.initials: M
authors.lastname: Aguilar-Guisado
authors.forename: Margarita
authors.initials: M
authors.lastname: Jiménez-Jambrina
authors.forename: Ildefonso
authors.initials: I
authors.lastname: Espigado
authors.forename: Montserrat
authors.initials: M
authors.lastname: Rovira
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Martino
authors.forename: Albert
authors.initials: A
authors.lastname: Oriol
authors.forename: Nuria
authors.initials: N
authors.lastname: Borrell
authors.forename: Isabel
authors.initials: I
authors.lastname: Ruiz
authors.forename: Pilar
authors.initials: P
authors.lastname: Martín-Dávila
authors.forename: Rafael
authors.initials: R
authors.lastname: de la Cámara
authors.forename: Miquel
authors.initials: M
authors.lastname: Salavert
authors.forename: Julián
authors.initials: J
authors.lastname: de la Torre
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Cisneros
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D011014:Pneumonia / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality*; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate; D014184:Transplantation, Homologous