Objective: to compare the incidence and the nature of infections in allogenic (AL) and autologous (AT) in BMTP. We report the results of a 4-years retrospective cohort study. Method: infectious episodes occuring in 454 BMT (93 AL and 361 AT) were analyzed in a retrospective study during a 4-year period (1993-1996). Results: 1557 micro organisms were isolated, bacteria : 39.2%, fungi : 54.2% and viruses : 6.6%. The most common culture positive specimens were stools and throat secretions. Coagulase negative staphylococci (CNS) represented 43% of all bacteria isolated and were the leading cause of bacteremia (62%) followed by viridans streptococci (VS) (12.6%), S. aureus (4.6%) and enterobacteria (3.4%). The incidence of CNS bacteremia was significantly higher in AL and in patients treated for ALL. Twenty percent of the SCN strains were susceptible to oxacilline, 66% to pefloxacine and 64% to gentamycine and the susceptibility was stable during the 4-year period. No difference was observed between AL and AT for VS bacteremia during the 4-year period. However, the incidence of VS bacteremia decreased significantly in AT patients from 1994 to 1996. Eighty percent of the strains were susceptible to amoxicillin and the susceptibility remained stable from 1993 to 1996. Most of the VS bacteremia occured on days 4 and 5 following the BMT and no bacteremia was observed after day 22. Invasive aspergillosis was diagnosed in 9 patients (8 AL and 1 AT), 3 patients being treated for ALL and 3 for AML. The incidence of Adenovirus and Cytomegalovirus (CMV) were significantly higher in AL. CMV infections were more frequent in patients with CCL. Conclusion: the results of this study should help to optimize the prevention and the therapy of infections in BMTP.
Full conference title:
38th Interscience Conference on Antimicrobial Agents and Chemotherapy
- ICAAC 38th