Document Detail


Microbial contamination of hematopoietic progenitor cell grafts-incidence, clinical outcome, and cost-effectiveness: an analysis of 735 grafts.
MedLine Citation:
PMID:  15934984     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Screening of progenitor cell grafts (marrow, peripheral blood, and cord blood) for microbial contamination is required by the standards of AABB. Clinical sequelae from infusion of these contaminated grafts, however, is uncommon. STUDY DESIGN AND METHODS: A retrospective analysis of 735 consecutive marrow and peripheral blood progenitor cell harvests between 1998 and 2003 was performed. Analysis included incidence, clinical outcome, and cost outcomes of positive blood cultures and antibiotic therapy. RESULTS: Thirty-three of 735 (4.5%) harvests were contaminated. The incidence of microbial contamination varied with the source of the graft (4 of 26 [15%] were cord blood, 8 of 177 [4.5%] were marrow, and 21 of 532 [3.9%] were peripheral blood). Coagulase-negative Staphylococcus (n=22) and Propionibacterium acnes (n=8) were most frequently isolated. Potentially pathogenic organisms were isolated in 6 of 735 (0.81%) grafts (methicillin-sensitive Staphylococcus aureus, 4; methicillin-resistant S. aureus, 1; and Enterobacter cloacae, 1). The estimated total cost of surveillance was approximately $81,585. The cost of vancomycin therapy in 4 patients who received prophylactic antibiotic therapy was approximately $10,000. No adverse sequelae followed infusion of contaminated grafts. CONCLUSION: Clinical sequelae following infusion of microbially contaminated progenitor cells is extremely rare. Prophylactic empiric antibiotics may be unnecessary. Routine microbial surveillance of progenitor cell grafts is a low-yield procedure.
Authors:
Rammurti Kamble; Shubham Pant; George B Selby; Mohamed A Kharfan-Dabaja; Sanjay Sethi; Kristen Kratochvil; Nancy Kohrt; Howard Ozer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transfusion     Volume:  45     ISSN:  0041-1132     ISO Abbreviation:  Transfusion     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-06-06     Completed Date:  2005-06-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  874-8     Citation Subset:  IM    
Affiliation:
Section of Hematology-Oncology and Bone Marrow Transplantation, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA. Rammurti-kamble@ouhsc.edu
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MeSH Terms
Descriptor/Qualifier:
Anti-Infective Agents / therapeutic use
Antibiotic Prophylaxis
Bacterial Infections / drug therapy,  economics*,  epidemiology*,  microbiology,  prevention & control,  transmission
Bone Marrow Cells / microbiology
Ciprofloxacin / therapeutic use
Cost-Benefit Analysis
Fetal Blood / microbiology
Hematopoietic Stem Cell Transplantation*
Hematopoietic Stem Cells / microbiology*
Humans
Incidence*
Retrospective Studies
Specimen Handling
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Infective Agents; 85721-33-1/Ciprofloxacin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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