title: Severe bacterial infections in patients with non-transfusion-dependent thalassemia: prevalence and clinical risk factors.
abstract: BACKGROUND
  Bacterial infection is one of the major causes of death in patients with thalassemia. Clinical predictive factors for severe bacterial infection were evaluated in patients with non-transfusion-dependent thalassemia (NTDT).
  
  
  METHODS
  A retrospective study was conducted of patients with NTDT aged ≥ 10 years at Srinagarind Hospital, Khon Kaen University, Thailand. Clinical characteristics and potential clinical risk factors for bacterial infection were collected. Risk factors for bacterial infection were evaluated by multivariate logistic regression analysis.
  
  
  RESULTS
  A severe bacterial infection was found in 11 of the total 211 patients with NTDT (5.2%). None of the clinical factors assessed was shown to be statistically associated with severe bacterial infection in patients with NTDT. However, three factors were demonstrated to be potential predictive factors for severe bacterial infection: time after splenectomy >10 years, deferoxamine therapy, and serum ferritin >1000 ng/ml. None of the patients died from infection.
  
  
  CONCLUSIONS
  The prevalence of bacterial infection in patients with NTDT was found to be moderate. Time after splenectomy >10 years, deferoxamine therapy, and iron overload may be clinical risk factors for severe bacterial infection in patients with NTDT. Bacterial infection should be recognized in splenectomized patients with NTDT, particularly those who have an iron overload.
authors.affiliation: Division of Hematology, Department of Internal Medicine, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. Electronic address: nattiya@kku.ac.th.
authors.forename: Nattiya
authors.initials: N
authors.lastname: Teawtrakul
authors.affiliation: Division of Hematology, Department of Pediatrics, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Arunee
authors.initials: A
authors.lastname: Jetsrisuparb
authors.affiliation: Division of Hematology, Department of Internal Medicine, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Chittima
authors.initials: C
authors.lastname: Sirijerachai
authors.affiliation: Division of Hematology, Department of Internal Medicine, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Kanchana
authors.initials: K
authors.lastname: Chansung
authors.affiliation: Division of Hematology, Department of Internal Medicine, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Chinadol
authors.initials: C
authors.lastname: Wanitpongpun
mesh_terms: D000293:Adolescent; D000328:Adult; D001424:Bacterial Infections / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D003676:Deferoxamine / Q000627:therapeutic use; D005260:Female; D005293:Ferritins / Q000097:blood; D006801:Humans; D019190:Iron Overload / Q000150:complications; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013156:Splenectomy; D013785:Thailand / Q000453:epidemiology; D013789:Thalassemia / Q000150:complications* / Q000188:drug therapy; D055815:Young Adult
chemical_list: D005293:Ferritins; D003676:Deferoxamine
keywords: Bacterial infection; Clinical risk factor; Non-transfusion-dependent thalassemia