Istanbul Faculty of Medicine, Department of Medical Microbiology, CAPA-ISTANBUL-TURKEY.
Istanbul Faculty of Medicine, Department of Internal Diseases, Bone Marrow Transplantation Unit CAPA-ISTANBUL-TURKEY.
New Microbiol. 2022 Jan;45(1):40-50. Epub 2021 Dec 11.
This study aims to evaluate the probable association between CMV infection and bacterial or fungalinfections in 91 consecutive adult patients who underwent autologous or allogeneic HSCT within aperiod of two years.The medical records of the patients were retrospectively reviewed. Blood cultures were evaluatedby an automated blood culture system. A quantitative real-time polymerase chain reaction was performedto detect CMV DNA.CMV infection and CMV disease were detected in 42 (46%) and six (6.6%) patients, respectively. Ofthe 158 microorganisms isolated, 115 (73%) were Gram-positive bacteria. Bacteremia and fungemiadeveloped in 55 (60%) and eight (8%) patients, respectively. Concurrent CMV infection and bacteremiawere detected in 17 (18.7%) patients and concurrent CMV infection and fungal infection weredetected in five (5.5%) patients. Graft versus host disease (GVHD) developed in 15 (50%) allogeneicHSCT recipients and two (2.2%) autologous HSCT recipients. Twenty-one (23%) patients including13 (43%) allogeneic and eight (13%) autologous HSCT recipients died.The most common infection is bacteremia, and it develops concurrently with CMV infection in approximatelyone-fifth of HSCT recipients. Gram-positive bacteria are more common in bacteremia.Further studies on the follow-up and treatment of infections after HSCT will improve post-HSCTsurvival rates.
本研究旨在评估 91 例连续成年患者中巨细胞病毒（CMV）感染与细菌或真菌感染之间可能存在的关联，这些患者在两年内接受了自体或同种异体 HSCT。回顾性分析患者的病历。通过自动血液培养系统评估血培养。进行实时定量聚合酶链反应以检测 CMV DNA。42 例（46%）和 6 例（6.6%）患者分别检测到 CMV 感染和 CMV 病。在分离的 158 种微生物中，115 种（73%）为革兰氏阳性菌。55 例（60%）发生菌血症，8 例（8%）发生真菌血症。17 例（18.7%）患者同时存在 CMV 感染和菌血症，5 例（5.5%）患者同时存在 CMV 感染和真菌感染。15 例（50%）异基因 HSCT 受者和 2 例（2.2%）自体 HSCT 受者发生移植物抗宿主病（GVHD）。21 例（23%）患者包括 13 例（43%）异基因和 8 例（13%）自体 HSCT 受者死亡。最常见的感染是菌血症，约五分之一的 HSCT 受者并发 CMV 感染。菌血症中革兰氏阳性菌更为常见。进一步研究 HSCT 后感染的随访和治疗将提高 HSCT 后的生存率。
