title: Incidence and predictors of respiratory viral infections by multiplex PCR in allogeneic hematopoietic cell transplant recipients 50 years and older including geriatric assessment.
abstract: Community respiratory viruses (CRV) are important agents of morbidity and mortality within the allogeneic hematopoietic stem cell transplant (HCT) population. Few proven methods to prevent CRV infections exist. No studies have specifically investigated their impact on older patients. We reviewed patients 50 years and older undergoing HCT between 2009-2013 to determine the incidence of CRV infection using multiplex PCR and risk factors for infection including geriatric assessment (GA). Thirty-two first episode CRV infections occurred in 118 patients for a 1-year cumulative incidence of 27.2% (CI: 19.4-35.6%). Hospitalization and mortality were restricted to those who developed lower respiratory tract infections (LRTI) (n = 22, 69%). CRV infection contributed to 8 deaths (36% of LRTIs) and 7 of these patients were taking steroids for GvHD at the time of infection. Health impairments by GA did not translate into increased risk for CRV infection. Steroid use at time of LRTI was associated with high mortality.
authors.affiliation: a Department of Medicine , University of Chicago ;
authors.forename: Christopher R
authors.initials: CR
authors.lastname: D'Angelo
authors.affiliation: b Department of Public Health Sciences , University of Chicago , IL, USA.
authors.forename: Masha
authors.initials: M
authors.lastname: Kocherginsky
authors.affiliation: a Department of Medicine , University of Chicago ;
authors.forename: Jennifer
authors.initials: J
authors.lastname: Pisano
authors.affiliation: a Department of Medicine , University of Chicago ;
authors.forename: Michael R
authors.initials: MR
authors.lastname: Bishop
authors.affiliation: a Department of Medicine , University of Chicago ;
authors.forename: Lucy A
authors.initials: LA
authors.lastname: Godley
authors.affiliation: a Department of Medicine , University of Chicago ;
authors.forename: Justin
authors.initials: J
authors.lastname: Kline
authors.affiliation: a Department of Medicine , University of Chicago ;
authors.forename: Richard A
authors.initials: RA
authors.lastname: Larson
authors.affiliation: a Department of Medicine , University of Chicago ;
authors.forename: Hongtao
authors.initials: H
authors.lastname: Liu
authors.affiliation: a Department of Medicine , University of Chicago ;
authors.forename: Olutoyosi
authors.initials: O
authors.lastname: Odenike
authors.affiliation: a Department of Medicine , University of Chicago ;
authors.forename: Wendy
authors.initials: W
authors.lastname: Stock
authors.affiliation: a Department of Medicine , University of Chicago ;
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Artz
mesh_terms: D000367:Age Factors; D000368:Aged; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000821:virology; D005260:Female; D015577:Geriatric Assessment; D005938:Glucocorticoids / Q000627:therapeutic use*; D006086:Graft vs Host Disease / Q000188:drug therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D008297:Male; D008875:Middle Aged; D060885:Multiplex Polymerase Chain Reaction; D010252:Paramyxoviridae / Q000302:isolation & purification*; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000821:virology; D012307:Risk Factors; D066027:Transplant Recipients; D019172:Transplantation Conditioning / Q000009:adverse effects*; D014184:Transplantation, Homologous / Q000009:adverse effects
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents
keywords: geriatric assessment; hematopoietic cell transplantation; incidence; respiratory viruses