Abstract
Background and Aims : The purpose of this study was to evaluate bacteremia after allogeneic stem cell transplant (before engraftment). We retrospectively reviewed the incidence and the timing of bacteremia, including the clinical course, complications, and associated clinical risk factors. Between January 1997 and September 2004, 117 patients received allogeneic stem cell transplants at our hospital.
Methods : All patients were kept in HEPA-filtered rooms (class 100) and inhaled amphotericin B. Of these, 100 were given oral polymyxin B sulfate (PL-B), amphotericin B, acyclovir, and sulfamethoxazole trimethoprium, while 17 were given vancomycin hydrochloride in addition to this prophylaxis.
Results : Among the 117 patients, 18 patients (15.2%) developed bacteremia. Cause of bacteremia were oral mucosa (6 patients), intestine (4 patients), catheter (2 patients), unknown (6 patients). Among 18 patients, blood culture isolated gram-positive organisms (10 patients), gram-negative organisms (6 patients), anaerobic bacterium (1 patient), Candida (1 patient). Bacteremia contributed directly to death in 3 caused by gram-negative organisms (pseudomonas, stenotrophomonas) and candida.
Conclusions : While bacteremia mortality was low, that caused by gram-negative organisms was fatal.
