title: Polymicrobial bacterial or fungal infections: incidence, spectrum of infection, risk factors, and clinical outcomes from a large hematopoietic stem cell transplant center.
abstract: BACKGROUND
  Infections cause significant morbidity and mortality for patients who undergo hematopoietic stem cell transplantation (HSCT). Cancer patients who develop polymicrobial infection (PI) are at increased risk for poor clinical outcomes, yet very limited data have been published within the HSCT setting.
  
  
  METHODS
  An observational study of 901 stem cell transplant recipients was conducted at Northwestern Memorial Hospital to identify the incidence, risk factors and outcomes for HSCT recipients who develop infection(s) with multiple bacterial or fungal organisms.
  
  
  RESULTS
  Among 901 HSCT recipients reviewed (675 autografts and 226 allografts), 237 patients (27%) had microbiologically documented microorganisms isolated, including 179 patients (76%) with monomicrobial infection and 59 patients (24%) with multiple microorganisms, of which 34 (14%) were classified as PI, and 25 (10%) as multiple distinct episodes of infection.
  
  
  CONCLUSIONS
  The results show co-infection with multiple organisms during HSCT is relatively rare; however, these patients are at an increased risk for the development of acute graft-versus-host disease, delayed engraftment, and overall mortality.
authors: Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA; Northwestern Memorial Hospital, Chicago, Illinois, USA.
authors: S
authors: S
authors: Trifilio
authors: Z
authors: Z
authors: Zhou
authors: J L
authors: JL
authors: Fong
authors: A
authors: A
authors: Zomas
authors: D
authors: D
authors: Liu
authors: C
authors: C
authors: Zhao
authors: J
authors: J
authors: Zhang
authors: J
authors: J
authors: Mehta
mesh_terms: D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology; D015331:Cohort Studies; D060085:Coinfection / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control*; D019337:Hematologic Neoplasms / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D007166:Immunosuppressive Agents
keywords: graft-versus-host disease; polymicrobial infection; stem cell transplantation