The Detection of Viral Infection in Bronchoalveolar Lavage Samples Collected From Recipients of Allogeneic Haematological Stem Cell Transplantation with Pneumonia (A 3 Year Epidemiological Study 20082010)

Eva Stepanova, Jr., MD*, Pavel Zak, MD, PhD2, Alzbeta Zavrelova, MD*, Melanie Cermanova, MD, PHD*, Jakub Radocha, MD*, Lenka Pliskova, Sr., MD*, Vlasta Stepanova, MD*, and Lukas Smolej, M.D., Ph.D.

Author address: 

2nd Internal Department - Division of Hematology, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic, 2nd Internal Department - Division of Hematology, University Hospital a Faculty of Medicine, Hra

Abstract: 

Background: Both radiological (chest X-rays and High Resolution Computed Tomography) and PCR methods are essential for viral pneumonia diagnostic procedures. Bronchoalveolar lavage (BAL) samples obtained from patients with signs of lower respiratory tract infection were tested and analysed for viral agents. Materials and methods: Forty seven BAL samples were obtained from 32 recipients (20 males and 12 females) of allogeneic haematological stem cell transplantation. Of those, 30 patients (93 %) were transplanted for haematological malignancy (52 % with acute myeloid leukemia, 12 % with chronic lymphatic leukemia) and 2 for aplastic anemia. BAL sampling was performed in locations of maximum signs of pathological process according to X-ray or HRCT. For testing, 4x 50 ml of F1/1 was installed in alveoli and 3rd and 4th portions were used. Viral infection diagnosis was based on real-time PCR detection of nucleic acid and/or immunochromatography detection of viral antigens. The following examinations were commonly performed on BAL samples: microscopic and cytologic examination (including staining for Pneumocystis jiroveci and branched fungi), cultivation (bacteriological, mycological and mycobacterial), real-time PCR (adenovirus, cytomegalovirus (CMV), herpes simplex virus (HSV) type 1,2, influenza virus A/B/H1N1, parainfluenza virus 1,2,3, respiratory syncytial virus (RSV), varicella zoster virus, rhinovirus, Epstein Barr virus, human metapneumovirus, Mycobacterium sp. et TBC, Streptococcus pneumoniae, Listeria monocytogenes, Chlamydia pneumoniae, Legionella pneumophila, Aspergillus fumigatus, panfungal DNA, Pneumocystis jiroveci (PCP)) and immunochromatography/immunofluorescence detection of antigens (Adenovirus, influenza virus A/B, respiratory syncytial virus, Chlamydia pneumoniae) and Aspergillus galactomannan. Results: Viral agents were detected in 20 (out of 47) samples (in some of those, several tests yielded more than one positive or grey zone result). No viral infection was detected in 27 samples. Dual viral infection was diagnosed in 4 cases. Overall, 20 tests proved significant viral load (104cp/ml) (see Tab. 1).
2011

abstract No: 

4577

Full conference title: 

53rd American Society of Haematology
    • ASH 53rd (2011)