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ctt-journal > Averjanova et al. (Abstract)

Averjanova et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 12
doi: 10.3205/ctt-2011-No12-abstract27

© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "5th Raisa Gorbacheva Memorial Meeting Hematopoietic Stem Cell Transplantation in Children and Adults", Saint Petersburg, Russia, September 18–20, 2011

Preliminary Program

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Bacterial infections in pediatric and adolescent allogeneic HSCT recipients

Maria Yu. Averjanova, Vladimir N. Vavilov, Sergei N. Bondarenko, Olga S. Uspenskaya, Ludmila S. Zubarovskaya, Boris V. Afanasyev

R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, St. Petersburg Pavlov State Medical University, St. Petersburg, Russia

Correspondence: Maria Yu. Averjanova, R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, Saint Petersburg Pavlov State Medical University, 6/8, Tolstoy str., St. Petersburg, 197022, Russia, E-mail: 26112008@spam is badrambler.ru


Aim: Bacterial infections (BI) are one of the main causes of mortality in allogeneic hematopoietic stem cell transplantation settings. This study aimed at an assessment of the pathogen spectrum and risk factors to allo-HSCT recipients.

Materials and methods: One hundred and fifty pediatric (0–14 y.o.) and adolescent (14–21 y.o.) patients who received allo-HSCT between 2009 and 2011 were included in the study. In each patient a blood, urine, or other culture positive for bacterial pathogen was obtained at least once.

Results: The incidence of BI caused by Gram-negative pathogens was slightly higher (56%) than of BI caused by Gram-positive bacteria. Before day +100 blood-borne pathogens (41%) and urinary tract infections (UTI) (28%) prevailed. Later, 39% of patients with BI were diagnosed with pneumonia (67% caused by multiple pathogens). In adolescent patients some local infections were more frequent than in pediatric patients: ear and sinus infections (30% vs 12%), UTI (41% vs 26%). The most important risk factors were disease progression, active graft-versus-host disease (GVHD), ongoing immunosuppressive therapy, chronic fecal infection. The most common blood-borne pathogens were S.еpidermidis (50%), Pseudomonas sp. (12.5%), and K.pneumoniae (8.7%). Most UTI were caused by E.coli (12%), K.pneumoniae (8%), and Pseudomonas sp. (6%). S.aureus (35%), K.pneumoniae (13.2%), and Pseudomonas sp. (1.3%) were prevalent in patients with pneumonia.

Conclusions: There is a slightly greater prevalence of Gram-negative bacteria. The most important risk factors for BI are GVHD, immunosuppressive therapy, advanced disease stage and chronic infection. The prevalent pathogens are Enterococcus sp. (37%), S.еpidermidis (27%), K.pneumoniae (27%), E.coli (16,5%), Pseudomonas sp. (15,5%), Enterobacter spp. (12%).

Keywords: allogeneic hematopoietic stem cell transplantation, bacterial infections, risk factors