The association of CMV infection with bacterial and fungal infections in hematopoietic stem cell transplant recipients: A retrospective single center study

Abstract

This study aims to evaluate the probable association between CMV infection and bacterial or fungal infections in 91 consecutive adult patients who underwent autologous or allogeneic HSCT within a period of two years.Medical records of the patients were retrospectively reviewed. Blood cultures were evaluated by automated blood culture system. A quantitative real-time polymerase chain reaction was performed to detect CMV DNA.CMV infection and CMV disease were detected in 42 (46%) ADDIN EN.CITE <EndNote><Cite><Author>Ng</Author><Year>2005</Year><RecNum>191</RecNum><DisplayText>(Ng<style face="italic"> et al., </style>2005)</DisplayText><record><rec-number>191</rec-number><foreign-keys><key app="EN" db-id="a20etv5e6ade0berxf1vw5vp0apvfptetwwd" timestamp="1639991687">191</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ng, A. P.</author><author>Worth, L.</author><author>Chen, L.</author><author>Seymour, J. F.</author><author>Prince, H. M.</author><author>Slavin, M.</author><author>Thursky, K.</author></authors></contributors><titles><title>Cytomegalovirus DNAemia and disease: incidence, natural history and management in settings other than allogeneic stem cell transplantation</title><secondary-title>Haematologica</secondary-title></titles><periodical><full-title>Haematologica</full-title></periodical><pages>1672-1679</pages><volume>90</volume><number>12</number><dates><year>2005</year><pub-dates><date>Dec</date></pub-dates></dates><isbn>0390-6078</isbn><accession-num>WOS:000506833800012</accession-num><urls><related-urls><url><Go to ISI>://WOS:000506833800012</url></related-urls></urls></record></Cite></EndNote>(Ng et al., 2005) and six (6.6%) patients, respectively. Of the 158 microorganisms isolated, 115 (73%) were Gram-positive bacteria. Bacteremia and fungemia developed in 55 (60%) and eight (8%) patients, respectively. Concurrent CMV infection and bacteremia were detected in 17 (18.7%) patients and concurrent CMV infection and fungal infection were detected in five (5.5%) patients. Graft versus host disease (GVHD) developed in 15 (50%) allogeneic HSCT recipients and two (2.2%) autologous HSCT recipients. Twenty-one (23%) patients including 13 (43%) allogeneic and eight (13%) autologous HSCT recipients died.The most common infection is bacteremia, and it develops concurrently with CMV infection in approximately one-fifth of HSCT recipients. Gram-positive bacteria are more common in bacteremia. Further studies on the follow-up and treatment of infections after HSCT will improve survival rates post-HSCT.