Document Detail


Nontuberculous mycobacterial infections in Chinese hematopoietic stem cell transplantation recipients.
MedLine Citation:
PMID:  13130319     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Between 1995 and 2002, nine cases of nontuberculous mycobacterium (NTM) were isolated from 462 allogeneic stem cell transplant (SCT) recipients (1.9%), and none from 139 autologous cases. They included three cases each of Mycobacterium fortuitum and M. chelonae, and single cases of M. scrofalaceum, M. gordonnae and M. avium complex. Seven cases were respiratory, including five cases requiring treatment, and two involved infected catheters and vascular conduits. Compared with nine cases of mycobacterium tuberculosis (MTB) isolated in the same period, NTM isolation occurred later after HSCT and involved more unrelated donors. Important risk factors for NTM infection included significant aGVHD (P=0.043), leukemia relapse (P=0.022), MUD and mismatch SCT (P<0.001) and existence of BO (P<0.001). Coinfection with aspergillus was common. Invasive NTM disease required prolonged antimicrobial treatment in five cases due to M. fortuitum and M. chelonae. With better MTB prophylaxis, intensive immunosuppression and better awareness, NTM has become an emerging threat in oriental allogeneic HSCT recipients. The cutoff between colonization and infection, and the threshold for starting treatment is unclear. NTM isolation is a marker for severe immunosuppression and poor prognosis. When there is doubt over species identity or extent of infection, broad-spectrum cover may be prudent.
Authors:
W Y Au; V C C Cheng; P L Ho; K Y Yuen; I Hung; S Y Ma; A K W Lie; R Liang; Y L Kwong
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Bone marrow transplantation     Volume:  32     ISSN:  0268-3369     ISO Abbreviation:  Bone Marrow Transplant.     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-09-17     Completed Date:  2004-06-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8702459     Medline TA:  Bone Marrow Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  709-14     Citation Subset:  IM    
Affiliation:
Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong. auwing@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aspergillosis / etiology
Catheterization / adverse effects
China / epidemiology
Female
Hematopoietic Stem Cell Transplantation / adverse effects*
Humans
Immunosuppression / adverse effects
Male
Middle Aged
Mycobacterium Infections / etiology*,  microbiology
Respiratory Tract Infections / etiology,  microbiology
Retrospective Studies
Risk Factors
Treatment Outcome

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


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