| Microbial contamination of hematopoietic progenitor cell grafts-incidence, clinical outcome, and cost-effectiveness: an analysis of 735 grafts. | |
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MedLine Citation:
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PMID: 15934984 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article |
Journal Detail:
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Title: Transfusion Volume: 45 ISSN: 0041-1132 ISO Abbreviation: Transfusion Publication Date: 2005 Jun |
Date Detail:
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Created Date: 2005-06-06 Completed Date: 2005-06-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0417360 Medline TA: Transfusion Country: United States |
Other Details:
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Languages: eng Pagination: 874-8 Citation Subset: IM |
Affiliation:
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Section of Hematology-Oncology and Bone Marrow Transplantation, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA. Rammurti-kamble@ouhsc.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anti-Infective Agents
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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:
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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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