title: Lack of evidence for a reciprocal interaction between bacterial and cytomegalovirus infection in the allogeneic stem cell transplantation setting.
abstract: Pathogenic interactions between bacteria and cytomegalovirus (CMV) may potentially occur early after allogeneic stem cell transplantation (allo-SCT). This possibility nevertheless has not been investigated in depth. This was a retrospective study that included 170 consecutive patients who underwent 173 allo-SCTs. Both bacterial infection (most of which were bacteremic) and CMV DNAemia were detected in 78 allo-SCTs (62.9%). In total, 51 and 32 episodes of bacterial infection preceded or occurred after CMV DNAemia detection, respectively. Both events were diagnosed concurrently in four allo-SCTs. The cumulative incidence of bacterial infection (of any type) over the study period was comparable in patients with or without a preceding episode of CMV DNAemia (P = 0.321). Cox proportional hazards regression analysis failed to identify CMV DNAemia as a significant risk factor for bacterial infection. Likewise, the cumulative incidence of CMV DNAemia within the study period was not significantly different in patients with or without a preceding episode of bacterial infection (P = 0.189). Furthermore, the occurrence of bacterial infection within episodes of active CMV infection had no apparent impact on the kinetics of CMV DNAemia. Our data, thus, do not support the existence of a bidirectional synergistic effect between bacterial infection and active CMV infection in the allo-SCT setting.
authors.affiliation: Microbiology Service, Fundación INCLIVA, Hospital Clínico Universitario, Valencia, Spain.
authors.forename: Víctor
authors.initials: V
authors.lastname: Vinuesa
authors.affiliation: Hematology Service, Fundación INCLIVA, Hospital Clínico Universitario, Valencia, Spain.|Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Solano
authors.affiliation: Microbiology Service, Fundación INCLIVA, Hospital Clínico Universitario, Valencia, Spain.
authors.forename: Estela
authors.initials: E
authors.lastname: Giménez
authors.affiliation: Hematology Service, Fundación INCLIVA, Hospital Clínico Universitario, Valencia, Spain.
authors.forename: José L
authors.initials: JL
authors.lastname: Piñana
authors.affiliation: Hematology Service, Fundación INCLIVA, Hospital Clínico Universitario, Valencia, Spain.
authors.forename: Juan Carlos Hernández
authors.initials: JC
authors.lastname: Boluda
authors.affiliation: Hematology Service, Fundación INCLIVA, Hospital Clínico Universitario, Valencia, Spain.
authors.forename: Paula
authors.initials: P
authors.lastname: Amat
authors.affiliation: Microbiology Service, Fundación INCLIVA, Hospital Clínico Universitario, Valencia, Spain. david.navarro@uv.es.|Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain. david.navarro@uv.es.
authors.forename: David
authors.initials: D
authors.lastname: Navarro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000150:complications; D001424:Bacterial Infections / Q000150:complications*; D003587:Cytomegalovirus; D003586:Cytomegalovirus Infections / Q000150:complications*; D004279:DNA, Viral / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D014184:Transplantation, Homologous / Q000009:adverse effects; D055815:Young Adult
chemical_list: D004279:DNA, Viral
keywords: CMV DNAemia; allogeneic stem cell transplantation; bacteremia; bacterial infection; cytomegalovirus