Abstract: Infections in Hematopoietic Stem Cell Transplantation Recipients in the Pre-Engraftment Period

Attili V.S. Suresh, Mudhasir Ahmed, V. Anuradha and Ratna Rao

DOI: http://dx.doi.org/10.15379/2408-9877.2015.02.01.03

Introduction: The recipients of the hematopoietic stem cell transplantation (HSCT) are at increased risk of a variety of infections due to their immunocompromised state. The severity of the immunocompromise differs depending upon host, underlying disease, comorbidities, type of transplantation, conditioning regimen, and immunosuppressive drugs. Pre-engraftment period is attended by neutropenia, mucosal barrier disruption, broad spectrum antibiotic usage and invasive procedures like central lines.

Aim: We sought to evaluate the type and frequency of the infections in the pre-engraftment period in our transplant center.

Methods and Results: We reviewed 17 HSCT cases done in our center over 24 months from August, 2011 upto August, 2013 which included 11 autologous and 6 allogeneic HSCT cases. We found a total of 20 febrile neutropenic episodes with 12 bacterial and 6 fungal infections. Eighteen of the 73 cultures were positive (24.65%). Nine out of 17 patients (52.94%) had at least one culture positive. Eight out of 11 bacteria were ESBL producing (extended spectrum beta lactamase) and one organism was only sensitive to colistin. Only 2 of the 12 bacteria were gram positive (16.67%). Only one stool test was positive for Clostridium deficile. We had only one culture documented fungal infection (Aspergillus sinusitis) and 5 presumed Aspergillus infections.