Pulmonary viral infection in hematologic patients with and without stemcell transplantation

Ref ID: 18420

Author:

Lilian Junker , Jörg Halter, Alexis Dumoulin, Daiana Stolz, Dominik Heim,
Martin Stern , Christoph Bucher, Jakob Passweg, Hans Hirsch,
Michael Tamm.

Author address:

Clinic of Pulmonary Medicine and Respiratory Cell Research,
University Hospital Basel, Basel, Switzerland;Clinic of Hematology, University Hospital Basel, Basel, Switzerland; Institute for Microbiology, University
Hospital Basel, Basel, Switzerland

Full conference title:

European Respiratory Congress

Abstract:

Pulmonary complications are frequent in hematologic patients. Regular investigation
of BAL fluid includes bacterial/fungal culture, staining and PCR for
mycobacteria, immunohistochemistry/Grocott staining for pneumocystis and cell
differentiation. The increasing use of PCR allows to search for different viruses.
In this study we analysed the diagnostic yield of a recently established multi
PCR for detection of 13 viruses. 219 hematologic patients underwent diagnostic
bronchoscopy with BAL from september 2009 to january 2011. 28 of patients
received high dose chemotherapy, 143 underwent allogeneic and 13 autologous
stemcell transplantation. Bacteria were cultured from 43 (20%) BALs: staphyloccocus
aureus, pseudomonas aeruginosa, streptococcus pneumoniae, enterococcus,
moraxella, enterobacteriaceae, klebsiella, corynebacterium, mycoplasma pneumoniae,
mycoplasma hominis, chlamydia pneumoniae, bordetella pertussis. There
were 7 cases of pneumocystis. In two patients we found mycobacterium gordonae.
Aspergillus was cultured in 4 cases. In 81 (37%) patients viruses were documented.
Most often we found rhinovirus (n=31; 14%), followed by CMV (n=18;
8%), HSV (n=13; 6%), RSV (n=10; 4.5%), coronavirus (n=8; 3.6%), adenovirus
(n= 7; 3.2%), parainfluenza- and metapneumovirus (each n=5; 2.2%), H1N1 (n=4;
1.8%), influenza (n=3; 1.4%), and HHV6 (n=1; 0.4%).
Summary and conclusion: The incidence of viral infections is very high in patients
with hematologic diseases and pulmonary symptoms. Multiplex PCR in the
BAL should be introduced as a routine diagnostic procedure in this specific patient
group allowing to withdraw or avoid antibiotic or antifungal therapy in many cases.

Abstract Number: P3491

Conference Year: 2011

Link to conference website: http://www.ers-education.org/ersMade/abstract_print_11/files/Abstract_book_2011.pdf

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